Renal Transplantation in Augmented Bladders

Not many years ago, children with congenital abnormalities of the lower urinary tract or with bladder dysfunction were denied renal transplantation because they were considered very high-risk recipients. However, in the past few decades, we learned that in children with poorly compliant, low-capacit...

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Bibliographic Details
Published in:Current urology reports 2014-08, Vol.15 (8), p.431-431, Article 431
Main Authors: Pereira, P. López, Urrutia, M. J. Martínez, Lobato, R., Jaureguizar, E.
Format: Article
Language:English
Subjects:
Child
Humans
Kidney Transplantation
Lower Urinary Tract Symptoms - complications
Lower Urinary Tract Symptoms - surgery
Medicine
Medicine & Public Health
Nephrology
Pediatric Urology (M Castellan and R Gosalbez
Reconstructive Surgical Procedures
Section Editors
Topical Collection on Pediatric Urology
Urinary Bladder - surgery
Urologic Surgical Procedures
Urology
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Summary:Not many years ago, children with congenital abnormalities of the lower urinary tract or with bladder dysfunction were denied renal transplantation because they were considered very high-risk recipients. However, in the past few decades, we learned that in children with poorly compliant, low-capacity bladders, augmentation cystoplasty (AC) can create a compliant, low-pressure reservoir that helps preserve the kidney graft. Although the incidence of symptomatic urinary tract infection (UTI) may be greater in pediatric transplant recipients with an AC than in those without, UTI is related more to noncompliance with clean intermittent catheterization or vesicoureteral reflux to the native kidney or graft than to the AC itself, and usually does not lead to impairment of graft function. Today, children with a bladder reconstruction may undergo transplantation with the same outcome (graft survival and function) as those with normal bladders, although there is some possibility of malignant transformation in the intestinal segment used to augment the bladder in these patients.
ISSN:1527-2737
1534-6285
DOI:10.1007/s11934-014-0431-4