Sager Cristian, Burek Carol, Durán Víctor, Corbetta Juan Pablo, Weller Santiago, Paz Enrique, López Juan Carlos
Urology Department, Hospital de Pediatría Dr. Juan P. Garrahan, Buenos Aires, Argentina.
Pediatr Surg Int. 2011 Apr;27(4):423-30. doi: 10.1007/s00383-010-2704-4. Epub 2010 Aug 31.
To determine whether surgical procedures of the lower urinary tract in patients with uropathies affect evolution of the graft in renal transplantation.
156 kidney transplantations were performed in 150 patients with end-stage renal failure due to urologic disorders. The patients were classified into three groups: A, patients who did not require surgery in the lower urinary tract; B, required surgery and preserved adequate bladder function, and C, required surgery due to vesical dysfunction.
Graft survival rates at 1 year were 93.38% in group A, 95.45% in group B and 93% in group C. Rates at 5 years post-transplantation were 82.45, 79.85 and 86.58% for each group, respectively (not significant). Complications were vesicoureteral stenosis: 2 in group A, 3 in B and 1 in C; vesicoureteral reflux: 1 in group A, 1 in B and 10 in C; distal ureteral necrosis: 2 cases in group A, 2 in B and 1 in C; upper urinary tract infection: 12, 23.1 and 42.2% in each group, respectively.
Children with reconstructed urinary tract may be good candidates for kidney transplantation despite the higher frequency of urinary infections. Thus, careful and strict post-surgical urologic follow-up is mandatory.
