Long-term outcome of kidney transplantation in patients with a urinary conduit: a case–control study

• Published in: International urology and nephrology 2013-04, Vol.45 (2), p.405-411
• Main Authors: Slagt, Inez K. B., IJzermans, Jan N. M., Alamyar, Mustafa, Verhagen, Paul C. M. S., Weimar, Willem, Roodnat, Joke I., Terkivatan, Türkan
• Format: Article
• Language: English
• Subjects: Adult; Case-Control Studies; Female; Humans; Kidney Transplantation; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Retrospective Studies; Time Factors; Treatment Outcome; Urinary Diversion; Urology; Urology - Original Paper; Young Adult
• ISSN: 0301-1623; 1573-2584
• DOI: 10.1007/s11255-013-0395-1

Purpose To study the short- and long-term outcomes of kidney transplantation in patients with a bladder augmentation or urinary diversion compared to patients with a kidney transplantation in a normal functional bladder. Patients and methods Between January 2000 and March 2011, 13 patients received 16 grafts into a reconstructed urinary tract. We performed a retrospective case–control study and matched each patient to 4 controls for donor and recipient gender and year of transplantation. Results Short- and long-term complications of kidney transplantation occurred in 12 patients, varying from urinary tract infections to medical hospitalization with or without surgical or radiological intervention. In 5 patients, a percutaneous nephrostomy (PCN) was placed followed by surgical re-intervention. In three patients, the grafts failed as a result of chronic rejection and were re-transplanted. There was no graft loss as a result of surgical complications or the reconstructed urinary tract. One-year patient and graft survival was 100 %. After five years, all patients were alive and seven of nine grafts (77.8 %) were functioning. Mean follow-up time was 4.3 years. Among the controls, 55 grafts were transplanted in 52 patients. Ten patients received a PCN. Five patients needed surgical re-intervention. In three patients, transplantectomy was performed for ongoing rejection. Three patients were re-transplanted. One patient had a failing graft 7.5 years post-transplantation and became dialysis dependent. Conclusion Kidney transplantation in patients with a reconstructed urinary tract has an increased complication rate. Nevertheless, the long-term results are comparable to patients with a normal urinary bladder.