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[Renal transplantation in children with lower urinary tract dysfunction]
Christine Grapin-Dagorno1, Julia Boubnova, Tim Ulinski
1Chirurgie viscérale pédiatrique, Hôpital Armand-Trousseau 26, rue du Dr Arnold Netter, 75012 Paris.
Bulletin De L'Academie Nationale De Medecine
|December 13, 2007
Summary
Renal transplantation is a viable option for children with lower urinary tract dysfunction, showing similar outcomes to those with upper urinary tract dysfunction. This study found no significant differences in graft survival or function between the two groups.
Area of Science:
- Pediatric Nephrology
- Urology
- Transplantation Surgery
Background:
- Lower urinary tract dysfunction can lead to kidney failure due to chronic infections and hypertension from incomplete bladder drainage.
- These complications can persist or recur even after renal transplantation.
- Comparing outcomes in patients with lower versus upper urinary tract dysfunction is crucial for optimizing transplant strategies.
Purpose of the Study:
- To compare the outcomes of renal transplantation in children with lower urinary tract dysfunction (Group A) versus upper urinary tract dysfunction (Group B).
- To evaluate infectious and surgical complications, patient and graft survival, and graft function post-transplantation.
Main Methods:
- A retrospective review of 127 kidney transplants in 118 children (November 1988 - October 2005).
- Patients were divided into Group A (lower urinary tract dysfunction, n=17) and Group B (upper urinary tract dysfunction, n=17).
- Outcomes assessed included complications, graft survival, and serum creatinine levels at 1, 5, and 10 years, analyzed using the Mann-Whitney test.
Main Results:
- Complications were slightly more frequent in Group A (7 vs. 3), but the difference was not statistically significant (p=0.246).
- Mean graft survival was comparable: 5.29 years in Group A and 5.97 years in Group B (p=0.76).
- Serum creatinine levels at 1, 5, and 10 years showed no significant differences between the groups (p > 0.75).
Conclusions:
- Renal transplantation is feasible and yields comparable results in children with both lower and upper urinary tract dysfunction.
- No significant differences were observed in patient survival, graft survival, or graft function between the two groups.
- These findings support the consideration of renal transplantation for pediatric patients with lower urinary tract dysfunction.
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