Renal transplantation in adults with abnormal bladders

Area of Science:

• Nephrology
• Urology
• Transplantation Immunology

Background:

• Patients with end-stage renal failure due to urologic abnormalities often have abnormal bladder function.
• Assessing renal transplant outcomes in patients with abnormal bladders is crucial for surgical planning and patient management.

Purpose of the Study:

• To compare the long-term outcomes of renal transplantation in patients with abnormal bladders versus those with normal bladders.
• To evaluate graft survival, patient survival, renal function, and the incidence of urinary tract infections in both groups.

Main Methods:

• Retrospective analysis of 73 renal transplants in 66 patients with abnormal bladders and 58 transplants in 54 patients with normal bladders.
• Comparison of actuarial graft and patient survival rates at 10 years.
• Assessment of current renal function (plasma creatinine) and incidence of urinary tract infections.

Main Results:

• Actuarial graft survival at 10 years was similar (66% abnormal vs. 61% normal bladders).
• Longer follow-up revealed a significantly better kidney half-life in normal bladders (29-33 years) compared to abnormal bladders (15 years).
• Patient survival at 10 years was 86% in both groups. Renal function was better in the normal bladder group. Urinary tract infections were problematic only in patients with abnormal bladders.

Conclusions:

• Renal transplantation into abnormal lower urinary tracts is successful.
• Careful preoperative evaluation and diligent post-transplant follow-up are essential for patients with abnormal bladders.
• Prophylactic antibiotics can reduce urinary tract infection incidence, particularly in patients with abnormal bladders.