RENAL TRANSPLANTATION AFTER BLADDER AUGMENTATION: HACETEPE EXPERIENCE

Today still there remains some questions about renal transplantation to the ones who had bladder augmentation due to improper bladder dynamics. From a lot of centers the reports with small numbers and short follow up periods are reported. Here we share our experience about the transplantation patients whose bladders were augmented. Between November 1975 and October 2002, 43 pediatric renal transplantations were performed. 3 of these had previous augmentation cystoplasty and the compliance and the capacity of the bladders were increased and transplantations were done from cadaver. Mean follow up time was 17 months (8-24 months). All the patients underwent augmentation cystoplasty before end stage renal disease period. Those patients were undertaken only immunosuppressive treatment. The achieved capacity after augmentation was 100 % (90-110 %) of expected capacity for age. Achieved compliance at capacity more than 7,6 times (5-10) of preaugmentation compliance. Those patients underwent cadaver renal transplantation mean of 47 months (24-60 months) after augmentation cystoplasty. Two of those patients did clean intermittent cathaterization (CIC) 3-6X1 times a day and last one no need of CIC. Those transplanted kidneys were functioning properly with mean creatinin rate of 0,8 mg/dl (0,7-0,9 mg/dl). No surgical complications were observed in any of the cases. Although the case number is limited, with appropriate drainage of augmented bladders, the transplanted kidney is not affected. No infection was encountered due to CIC and no metabolic abnormality was observed. As a result in the cases which bladder dynamics are impaired augmentation and transplantation together increase the quality of life.