Renal Transplantation in Patients with Lower Urinary Tract Dysfunction: A Single Center Experience from a Developing Country
- *Corresponding Author:
- Dr. Muhammed Mubarak
Sindh Institute of Urology and Transplantation
Tel: 09221 9215752
Fax: 009221 2726165
E-mail: [email protected]
Received Date: September 27, 2012; Accepted Date: September 28, 2012; Published Date: October 10, 2012
Citation: Mohsin R, Hashmi A, Mubarak M, Shehzad A, Sultan G, et al. (2012) Renal Transplantation in Patients with Lower Urinary Tract Dysfunction: A Single Center Experience from a Developing Country. J Transplant Technol Res 2: 115. doi: 10.4172/2161-0991.1000115
Copyright: © 2012 Mohsin R, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objectives: Historically, patients with lower urinary tract dysfunction (LUTD) were considered poor candidates for renal transplantation (RT). We aimed to review our experience with this procedure for its safety and efficacy.
Methods: We reviewed the case records of patients with LUTD who underwent RT at our center. Graft and patient survival were analyzed.
Results: Out of 2053 RTs, 26 (1.2%) patients had LUTD as the primary cause of end-stage renal disease (ESRD). All patients underwent cystourethroscopy prior to transplantation, had abnormal bladders and all underwent bladder augmentation. Only 16 (61.5%) patients had urodynamic (UDN) evaluation prior to transplantation. Pretransplantation augmentation cystoplasty (AC) was performed in 24 (92.3%) patients, and post-RT in two (7.7%). Mitrofanoff channel was made in 25 (96.1%) patients using appendix in 14 (56%) patients and native ureter in 11 (44%). Double-J (DJ) stents were placed in all patients peroperatively. All patients developed 156 episodes of urinary tract infections (UTIs), with an average of 6 UTIs/ patient. All patients except three are maintaining their graft function within acceptable limits. We observed 100% patient and graft survival rates in this series.
Conclusions: In conclusion, RT combined with AC is a feasible option for patients with LUTD with good results in the medium term and should be explored in selected patients.