21 May 2009
Lower urinary tract reconstruction in a kidney transplant patient with neurogenic bladder
I Bałasz-Chmielewska, I Zagożdżon, M Drożyńska-Duklas, L Komasara, A Gołębiewski, P Czauderna, A ŻurowskaAnn Transplant 2009; 14(1): 59-60 :: ID: 880415
Abstract
Background: Patients with neurogenic bladder who are qualified for kidney
transplantation require a thorough preparation of urinary tract for a correct
outflow of urine from the transplanted kidney. Preferably, reconstruction
procedures should be performed prior to transplantation.
Material/Methods: This report presents a case of a 25-year old patient with
neurogenic bladder due to myelomeningocele (MMC), who underwent kidney transplantation in February 2004. The procedure was preceded by a 3-year long period of anuria. Prior to transplantation bladder volume was decreased (220 ml) and the detLPP (detrusor leak point pressure) increased (>40 cm H[sub]2[/sub]0) without signs of vesicoureteral reflux. During the first two years after transplantation the patient experienced numerous episodes of urinary tract infections (UTI), including five episodes of acute pyelonephritis in transplanted kidney. The LPP increased to 70 cm H[sub]2[/sub]0, voiding cystourethrography revealed a significant vesicoureteral reflux to the transplanted kidney, and creatinine levels rose from 0.9 to 1.6 mg/dl. In order to protect further graft deterioration a cystoplasty was performed with a Meinz-Pouch procedure followed by Mitrofanoff appendicovesicostomy in November 2006.
Results: A marked decrease in the frequency of UTI and improvement of graft function has been observed.
Conclusions: Although in patients with neurogenic bladder the optimal time for reconstruction procedures is before kidney transplantation, it can also be performed after grafting.
Keywords: Kidney Transplantation, case report, clinical outcome
In Press
15 Mar 2024 : Review article
Approaches and Challenges in the Current Management of Cytomegalovirus in Transplant Recipients: Highlighti...Ann Transplant In Press; DOI: 10.12659/AOT.941185
18 Mar 2024 : Original article
Does Antibiotic Use Increase the Risk of Post-Transplantation Diabetes Mellitus? A Retrospective Study of R...Ann Transplant In Press; DOI: 10.12659/AOT.943282
20 Mar 2024 : Original article
Transplant Nephrectomy: A Comparative Study of Timing and Techniques in a Single InstitutionAnn Transplant In Press; DOI: 10.12659/AOT.942252
28 Mar 2024 : Original article
Association Between FEV₁ Decline Rate and Mortality in Long-Term Follow-Up of a 21-Patient Pilot Clinical T...Ann Transplant In Press; DOI: 10.12659/AOT.942823
Most Viewed Current Articles
05 Apr 2022 : Original article
Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver TransplantationDOI :10.12659/AOT.935604
Ann Transplant 2022; 27:e935604
12 Jan 2022 : Original article
Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...DOI :10.12659/AOT.934738
Ann Transplant 2022; 27:e934738
22 Nov 2022 : Original article
Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...DOI :10.12659/AOT.937988
Ann Transplant 2022; 27:e937988
15 Mar 2022 : Case report
Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...DOI :10.12659/AOT.935860
Ann Transplant 2022; 27:e935860