Stanley O H, Chambers T L, Pentlow B D
Br Med J (Clin Res Ed). 1983 Jun 4;286(6380):1775-6. doi: 10.1136/bmj.286.6380.1775.
Children with neurogenic bladders have usually not been considered for renal transplantation because of the potential complications caused by chronic infections of the urinary tract. Two girls with occult neurogenic bladders who were practising intermittent self catheterisation were given renal transplants. Both took prophylactic antibacterial agents after transplantation, and both experienced infections at some stage, but none of these infections produced a deterioration in renal function. In one patient creatinine clearance fell and signs of obstruction appeared, but this was because the patient had been catheterising herself only two or three times a week. When she resumed catheterisation four times a day creatinine clearance rose and the urographic and renographic appearances returned to normal. These results suggest that, with adequate catheterisation and urinary chemoprophylaxis, infection is not a particular problem in children with bladder dysfunction who undergo renal transplantation.
由于慢性尿路感染可能引发的并发症，患有神经源性膀胱的儿童通常不被考虑进行肾移植。两名患有隐匿性神经源性膀胱且正在进行间歇性自我导尿的女孩接受了肾移植。两人在移植后均服用了预防性抗菌药物，并且两人在某个阶段都经历了感染，但这些感染均未导致肾功能恶化。在一名患者中，肌酐清除率下降且出现梗阻迹象，但这是因为该患者每周仅进行两三次自我导尿。当她恢复每天导尿四次时，肌酐清除率上升，尿路造影和肾造影表现恢复正常。这些结果表明，通过充分的导尿和尿路化学预防，感染对于接受肾移植的膀胱功能障碍儿童而言并非特别问题。
