TURKISH TRANSPLANTATION SOCIETY: RECENT ADVANCES IN TISSUE AND ORGAN TRANSPLANTATIONEndoscopic treatment of vesicoureteral reflux in renal transplant candidates
Section snippets
Patients and methods
Subureteral injection was performed in a total of 32 renal units in 17 patients (7 males, 10 females). Fifteen patients had bilateral, and two patients had unilateral, reflux. Fourteen of the patients had siloxane injected, and three received bovine collagen. The decision regarding type of injected material used was based solely on cost, particularly when higher volumes were considered necessary.
Half of the patients were anuric, and the others had daily urine outputs of 700 to 2500 mL, with a
Results
In all patients, the procedure was completed within 30 minutes. Postoperative recovery was uneventful. The patients were discharged 24 hours after the procedure, once their urethral catheter was removed. Complete response was achieved in 24 of 32 renal units (75%) and reflux grades dropped to grade I in 4 units (12.5%), resulting in an overall response rate of 87.5% (Table 1). The procedure was unsuccessful in 4 of the renal units.
Four of the patients underwent living-related renal
Conclusions
The outcome of renal transplantation in patients with high-grade reflux to native kidneys can be very disappointing due to postoperative urinary tract infection.1, 2 Nephroureterectomy is an invasive treatment modality used for transplant candidates with VUR, and also results in elimination of native endocrine function when done bilaterally.7 In addition, for dialysis patients who are still able to excrete urine, liberal water intake is no longer possible after nephrectomy. Reimplantation
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Cited by (8)
Transplantation and the Abnormal Bladder
2008, Kidney Transplantation: Principles and PracticeTransplantation and the Abnormal Bladder
2008, Kidney TransplantationUse of collagen injections for vesicoureteral reflux in transplanted kidneys
2003, Transplantation ProceedingsRenal transplant outcome after endoscopic treatment of vesicoureteral reflux using the subureteric injection of calcium hydroxyapatite
2010, Experimental and Clinical TransplantationPertinent issues in pretransplant recipient workup
2007, Indian Journal of UrologySubureteral dextranomer/hyaluronic acid copolymer injection for vesicoureteral reflux in transplant candidates
2005, Journal of Endourology