Transplanting patients with abnormal lower urinary tracts

Since 1977, 23 patients with bladder or bladder outlet dysfunction leading to renal failure have received 28 kidney transplants in our institution. Three patients were provided with an ileal conduit, but the remainder were transplanted using their own bladder following urodynamic assessment and bladder reconstruction. Graft and patient survival were good when compared to a group of patients with normal lower urinary tracts, actuarial graft survival at 5 years being 70% for both groups and patient survival being 82% and 90%, respectively. Patients who develop renal failure from detrusor/sphincter dysfunction can be transplanted successfully once the cause of the renal failure has been identified and corrected.