[Renal transplantation in urinary diversions]

Area of Science:

• Urology
• Transplantation Medicine
• Nephrology

Background:

• Renal transplantation into augmented bladders or urinary diversions represents a rare subset, comprising 1-2% of all procedures.
• End-stage renal disease in these patients often stems from lower urinary tract dysfunction, necessitating lower urinary tract reconstruction prior to transplantation.
• Urinary diversion is typically performed months before renal transplantation, with continent urinary diversions gaining popularity alongside ileum conduits.

Purpose of the Study:

• To evaluate the outcomes and complications of renal transplantation in patients with augmented bladders or urinary diversions.
• To compare the long-term graft survival in these patients to those with healthy native bladders.

Main Methods:

• Review of renal transplantations performed in patients with augmented bladders or urinary diversions.
• Analysis of complication rates, focusing on bacteriuria and urinary tract infections.
• Comparison of long-term graft survival data.

Main Results:

• The most common complications observed were bacteriuria and urinary tract infections.
• These infections were generally manageable with appropriate antibiotic treatment and did not typically result in graft loss.
• Long-term outcomes for renal transplantations in urinary diversions were found to be comparable to those in healthy native bladders.

Conclusions:

• Renal transplantation into augmented bladders or urinary diversions is a viable option for patients with end-stage renal disease due to lower urinary tract dysfunction.
• While infections are a frequent concern, they can be effectively managed, ensuring comparable long-term graft survival to standard renal transplantations.