TURKISH TRANSPLANTATION SOCIETY: RECENT ADVANCES IN TISSUE AND ORGAN TRANSPLANTATION
Endoscopic treatment of vesicoureteral reflux in renal transplant candidates

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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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