Churchill B M, Jayanthi R V, McLorie G A, Khoury A E
Clark/Morrison Children's Urology Center, UCLA School of Medicine 90095-1738, USA.
Pediatr Nephrol. 1996 Feb;10(1):113-20. doi: 10.1007/BF00863462.
Many children with end-stage renal disease have significant urinary tract problems other than irreversible loss of native kidney function. These significant other urinary tract problems, if not corrected prior to transplantation, may significantly increase recipient mortality, graft loss, and patient morbidity. These other urinary tract problems may cause hydroureteronephrosis in the transplanted kidney, lead to an increased incidence of graft rejection, be the source of sepsis after subsequent immunosuppression, and cause hypertension. In addition, pre-existing urinary diversion, large interabdominal masses, or previous cancer require specific pre-transplant management plans. Potential pediatric transplant recipients with other significant urinary tract problems can be classified according to three parameters; anatomical extent, pathology, and pathophysiology of the significant other problems. Particular attention must be paid to pre-existing lower tract problems. Strategy must be worked out pre transplant as to how the lower urinary tract is going to store, hold, and empty urine. The means for assessing the potential recipients and strategies and techniques for correcting pre-existing problems have been summarized in this article.
许多终末期肾病患儿除了原生肾功能不可逆转丧失外，还存在严重的泌尿系统问题。这些严重的其他泌尿系统问题，如果在移植前未得到纠正，可能会显著增加受者死亡率、移植物丢失率和患者发病率。这些其他泌尿系统问题可能导致移植肾发生肾盂积水，导致移植物排斥反应的发生率增加，成为后续免疫抑制后败血症的来源，并引发高血压。此外，既往存在的尿流改道、腹腔内巨大肿块或既往癌症需要特定的移植前管理计划。患有其他严重泌尿系统问题的潜在儿科移植受者可根据三个参数进行分类：其他严重问题的解剖范围、病理和病理生理学。必须特别关注既往存在的下尿路问题。移植前必须制定策略，确定下尿路将如何储存、容纳和排空尿液。本文总结了评估潜在受者的方法以及纠正既往存在问题的策略和技术。
