pISSN 2671-8790 eISSN 2671-8804

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Korean J Transplant 2020; 34(4): 238-243

Published online December 31, 2020

https://doi.org/10.4285/kjt.20.0046

© The Korean Society for Transplantation

Renal transplantation in patients with an augmentation cystoplasty

Jin Sun Choi , Hyunmin Ko , Hyo Kee Kim , Chris Chung , Ahram Han , Seung-Kee Min , Jongwon Ha , Sangil Min

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

Correspondence to: Sangil Min
Department of Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
Tel: +82-2-2072-2330
Fax: +82-2-766-3975
E-mail: surgeonmsi@gmail.com

Received: October 5, 2020; Revised: October 25, 2020; Accepted: October 25, 2020

Abstract

Background: The effects of renal transplantation in patients with augmentation cystoplasty 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 operation requiring a high level of surgical skill. Based on our long-term experiences, we recommend diligent postoperative monitoring for urinary tract infections, optimal catheter use, and use of appropriate antibiotic prophylaxis to avoid severe complications.

Keywords: Kidney transplantation, Bladder augmentation, Cystoplasty

HIGHLIGHTS
  • Renal transplantation after bladder augmentation surgery is a major operation requiring a high level of surgical skill.

  • Based on our long-term experiences, we recommended diligent postoperative monitoring for urinary tract infection, optimal catheter use, and use of appropriate antibiotic prophylaxis to avoid severe complications.