Transvesical Ureteroneocystostomy of Vesicoureteral Reflux in Renal Transplant Recipients.
- Author:
Seung Ruy LEE
1
;
Dong Suk KIM
;
Dong Jun KIM
;
Kang Su CHO
;
Koon Ho RHA
;
Seung Choul YANG
Author Information
1. Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Kidney transplantation;
Vesico-ureteral reflux;
Reimplantation
- MeSH:
Creatinine;
Diagnosis;
Follow-Up Studies;
Humans;
Incidence;
Kidney;
Kidney Transplantation;
Male;
Pyelonephritis;
Replantation;
Retrospective Studies;
Transplantation*;
Transplants;
Ureter;
Urinary Tract Infections;
Vesico-Ureteral Reflux*
- From:Korean Journal of Urology
2004;45(4):354-359
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Vesicoureteral reflux (VUR) in a transplanted kidney may affect the function of a grafted kidney with a recurrent urinary tract infection (UTI), and is a factor of graft failure. Our experience of surgical correction was investigated by performing transvesical ureteral reimplantation in VUR recipients. MATERIALS AND METHODS: Among 2,265 recipients, who had received a living kidney transplantation at Yonsei University Severance Hospital between April 1979 and October 2003, and 29 VUR recipients (7 Men, 22 Women), diagnosed with VCUG after recurrent UTI, were retrospectively analyzed. The mean age of the patients was 43.9, ranging from 24 to 61 years, with a mean follow up of 3.6, ranging from 0.7 to 8.0 years. The changes in the serum creatinine and complications after a transvesical ureteral reimplantation were analyzed. RESULTS: The incidence of VUR was 1.28% (29/2,265) and the mean diagnosis was made after 5.0, ranging from 0.8 to 13.4 years. The grades of VUR were 2 (I), 2 (II), 20 (III) and 5 (IV). Twenty-five recipients underwent a transvesical ureteral reimplantation. The mean serum creatinine decreased from 2.5+/-2.2 to 1.8+/-1.4mg/dl (p=0.14) 1 year after surgical correction, and was significantly decreased from 2.5+/-2.2 to 1.4+/-0.7mg/dl (p=0.017) 3 years after surgical correction. There were no UTI and acute pyelonephritis after a ureteral reimplantation. CONCLUSIONS: VUR, with recurrent UTI, in recipients administered an immunosuppressive agent may cause deterioration of the graft function. The suspicion of VUR should be borne in mind for renal recipients with recurrent UTI, which can be safely corrected by a transvesical ureteral reimplantation.
