H-Index
34
Scimago Lab
powered by Scopus
JCR
Clarivate
Analytics
call: +1.631.629.4327
Mon-Fri 10 am - 2 pm EST

Logo

MSMbanner
Medical Science Monitor Basic Research

AmJCaseRep
MedSciTechnol

eISSN: 2329-0358

Get your full text copy in PDF

Long-Term Outcomes of Kidney Transplant Recipients with Bladder Dysfunction: A Single-Center Study

Dushyanth Srinivasan, John T. Stoffel, Amit K. Mathur, Steven Kapeles, Kori Bradley, Randall S. Sung

(Department of Surgery, University of Michigan, Ann Arbor, MI, USA)

Ann Transplant 2016; 21:222-234

DOI: 10.12659/AOT.895975


BACKGROUND: Long-term outcomes of kidney transplantation recipients with bladder dysfunction or prior bladder surgery are not well characterized.
MATERIAL AND METHODS: Electronic records of 1753 recipients of kidney-alone transplant between January 2000 and December 2008 were reviewed. We found that 1652 recipients had normal bladder function, 80 had bladder dysfunction, and 21 had bladder substitute or urinary diversion. Kaplan-Meier survival curves and multivariable regression modeling were performed to determine survival outcomes.
RESULTS: Kaplan-Meier graft survival (p=.11) and patient survival (p=.18) were lower in recipients with bladder surgery but not statistically significant. Multivariate analysis demonstrated inferior graft survival (HR 3.57, 95% CI 1.06–12.1, p =0.04) and a trend towards inferior patient survival (HR 3.19, 95% CI .71–14.5, p=0.13) in reci­pients with bladder surgery. The major cause of graft failure was chronic rejection for normal function (17.1%) and bladder dysfunction (28.5%), and infection for bladder surgery (28.5%). Post-operative urinary infectious and surgical complications were higher in recipients with bladder dysfunction (35%) and substitutes (52.3%) compared with normal function (12.8%).
CONCLUSIONS: Kidney transplant recipients with prior bladder surgery have an increased risk of graft failure and an increased risk of infectious urinary complications. These risks should be considered in recipient selection and post-transplant management.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree