Korean J Transplant.  2020 Dec;34(4):238-243. 10.4285/kjt.20.0046.

Renal transplantation in patients with an augmentation cystoplasty

• Choi JS
• Ko H
• Kim HK
• Chung C
• Han A
• Min SK
• Ha J
• Min S

• KMID: 2510258
• DOI: http://doi.org/10.4285/kjt.20.0046

Abstract

Background
The effects of renal transplantation in patients with augmentation cysto- plasty are still controversial. We retrospectively analyzed nine patients who underwent renal transplantation after augmentation cystoplasty.
Methods
A total of nine patients who underwent augmentation cystoplasty prior to renal transplantation between January 1990 and May 2020 were reviewed. Basic information on augmentation cystoplasty, transplant procedures, and long-term outcomes of renal transplantation were analyzed.
Results
The bowel segments utilized for augmentation cystoplasty were the stomach in two patients (one patient needed revision using the ileum), the ileum in four patients, the ileocolic pouch in one patient, the sigmoid in one patient, and the ureter in one patient. All the cystoplasties were performed prior to renal transplantation. The mean follow-up period after transplantation was 161 months (range, 2–341 months). Two patients had an episode of acute rejection each; however, their graft functions were well-maintained. Five patients had recurrent urinary tract infections, and three of these patients progressed to allograft failure. One patient died from bladder cancer with a functioning graft. Five of nine patients showed well-maintained graft function.
Conclusions
Renal transplantation after bladder augmentation surgery is a major oper-ation requiring a high level of surgical skill. Based on our long-term experiences, we rec-ommend diligent postoperative monitoring for urinary tract infections, optimal catheter use, and use of appropriate antibiotic prophylaxis to avoid severe complications.

Keyword

Kidney transplantation; Bladder augmentation; Cystoplasty