title: Renal transplantation in children weighing <15 kg: does concomitant lower urinary tract dysfunction influence the outcome?
abstract: BACKGROUND
  We reviewed our experience with renal transplantation (RTx) in children weighing <15 kg to determine if the presence of lower urinary tract dysfunction (LUTD) influenced the outcome.
  
  
  METHODS
  Between 1987 and 2012, 68 RTx were performed in patients weighing less than 15 kg, including 17 with associated LUTD and 51 without. We detailed the lower urinary tract management in these patients, and compared graft survival rates and estimated clearance 12 and 60 months after RTx between groups.
  
  
  RESULTS
  None of the patients without LUTD required any lower urinary tract surgery vs 8 out of 17 (47 %) with LUTD (p = 0.0001). The latter included a temporary incontinent urinary diversion in 5 cases (29 %), namely 2 vesicostomies and 3 cutaneous ureterostomies. After comparable follow-ups, there was no difference in patient survival, graft survival, and glomerular filtration rates between groups.
  
  
  CONCLUSIONS
  Provided that there is appropriate bladder management, a concomitant LUTD does not adversely influence the outcome of RTx in patients weighing less than 15 kg. However, 50 % of our patients required lower urinary tract reconstruction and, in 30 %, a temporary incontinent urinary diversion was placed at RTx, since lower urinary tract function could not be assessed reliably, the patient was not collaborative enough to be involved in a voiding program, and/or the RTx was prioritized.
authors.affiliation: Paediatric Nephrology Unit, Department of Paediatrics, University Hospital of Padova, Via Giustiniani, 2, 35128, Padua, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Ghirardo
authors.forename: Paola
authors.initials: P
authors.lastname: Midrio
authors.forename: Pietro
authors.initials: P
authors.lastname: Zucchetta
authors.forename: PierGiorgio
authors.initials: P
authors.lastname: Gamba
authors.forename: GiovanniFranco
authors.initials: G
authors.lastname: Zanon
authors.forename: Luisa
authors.initials: L
authors.lastname: Murer
authors.forename: Marco
authors.initials: M
authors.lastname: Castagnetti
mesh_terms: D001835:Body Weight; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D059411:Lower Urinary Tract Symptoms / Q000150:complications*; D008297:Male; D010372:Pediatrics; D012189:Retrospective Studies; D014551:Urinary Tract / Q000002:abnormalities*