Professional paper

KIDNEY TRANSPLANTATION IN PATIENTS WITH PREVIOUSLY PERFORMED URINARY DIVERSION AND BLADDER AUGMENTATION

DEAN MARKIĆ orcid.org/0000-0001-5696-0850 ; Rijeka University Hospital Centre, Department of Urology, Rijeka, Croatia
JOSIP ŠPANJOL ; Rijeka University Hospital Centre, Department of Urology, Rijeka, Croatia
ROMANO OGUIĆ ; Rijeka University Hospital Centre, Department of Urology, Rijeka, Croatia
KRISTIAN KRPINA ; Rijeka University Hospital Centre, Department of Urology, Rijeka, Croatia
ANTUN GRŠKOVIĆ ; Rijeka University Hospital Centre, Department of Urology, Rijeka, Croatia
DRAŽEN RAHELIĆ ; Rijeka University Hospital Centre, Department of Urology, Rijeka, Croatia
LIDIJA ORLIĆ ; Rijeka University Hospital Centre, Division of Nephrology, Dialysis and Transplantation, Rijeka, Croatia
NINO RUBINIĆ ; Rijeka University Hospital Centre, Department of Urology, Rijeka, Croatia
MAURO MATERLJAN ; Rijeka University Hospital Centre, Department of Urology, Rijeka, Croatia
SANJIN RAČKI orcid.org/0000-0002-3736-0929 ; Rijeka University Hospital Centre, Division of Nephrology, Dialysis and Transplantation, Rijeka, Croatia

Abstract

Kidney transplantation is the most effective treatment for patients with end-stage renal disease. The prerequisite for kidney transplantation is the normal lower urinary tract system. In some patients with congenital or acquired disorders of the lower urinary tract, it is necessary to form adequate urinary diversion or bladder augmentation. This should be done prior to kidney transplantation. We present experience from our center with renal transplantation using urinary diversion or bladder augmentation. At Department of Urology, Rijeka University Hospital Centre, 1135 kidney transplantations were performed between January 30, 1971 and May 17, 2018. We retrospectively analyzed transplant patients with urinary diversion or bladder augmentation. During the observed period, we performed 6 kidney transplantations in patients with urinary diversion or bladder augmentation. Ileum conduit was performed in 3 patients, and Mainz pouch I and Mainz pouch III in one patient each. One patient had bladder augmentation with colon. The cause for urinary reconstruction was neurogenic bladder (3 patients), bladder cancer (2 patients) and posterior urethral valve (1 patient). Transplantation was heterotopic in five patients and orthotopic in one patient. One-year graft survival was 83% and one-year patient survival was 100%. In one patient, graftectomy was performed because of venous thrombosis. One patient died four years after transplantation because of pleural mesothelioma but with functional graft. All other grafts are still in function (1-23 years after kidney transplantation). Patients with urinary diversion and bladder augmentation could be successfully transplanted. Instead of more complicated operation, long-term results are comparable with the results of standard transplant population. This must encourage us to include patients with urinary diversion and bladder substitution on the waiting list for kidney transplantation.

Keywords

kidney transplantation; urinary diversion; end-stage renal disease

Hrčak ID:

229948

URI

https://hrcak.srce.hr/229948

Publication date:

5.12.2019.

Article data in other languages: croatian

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