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LONG-TERM FOLLOWUP OF CADAVERIC RENAL TRANSPLANTATION IN PATIENTS WITH SPINA BIFIDA

2002; Lippincott Williams & Wilkins; Volume: 167; Issue: 2 Part 1 Linguagem: Inglês

10.1016/s0022-5347(01)69067-0

1527-3792

Richard Power, Kiaran O’Malley, Dilly Little, M. G. Donovan, Tom Creagh, Denis Murphy, David P. Hickey,

Spinal Dysraphism and Malformations

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Feb 2002LONG-TERM FOLLOWUP OF CADAVERIC RENAL TRANSPLANTATION IN PATIENTS WITH SPINA BIFIDA RICHARD E. POWER, KIARAN J. O'MALLEY, DILLY M. LITTLE, MARY G. DONOVAN, TOM A. CREAGH, DENIS M. MURPHY, and DAVID P. HICKEY RICHARD E. POWERRICHARD E. POWER , KIARAN J. O'MALLEYKIARAN J. O'MALLEY , DILLY M. LITTLEDILLY M. LITTLE , MARY G. DONOVANMARY G. DONOVAN , TOM A. CREAGHTOM A. CREAGH , DENIS M. MURPHYDENIS M. MURPHY , and DAVID P. HICKEYDAVID P. HICKEY View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)69067-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Access related problems in hemodialysis and peritoneal dialysis are increased in cases of spina bifida due to vascular and body habitus limitations. Reports of renal transplantation in this patient group are exceedingly rare. We report long-term followup data on cadaveric renal transplantation for end stage renal failure in cases of spina bifida. Materials and Methods: Between February 1986 and April 2000, 17 cadaveric renal transplants were performed in 11 females and 5 males with spina bifida. Mean age at transplantation was 20.2 years (range 10 to 35). Of the patients 11 were wheelchair bound and 5 were independently mobile. Before transplantation surgical management of the urological tract included clean intermittent self-catheterization in 3 cases, enterocystoplasty and clean intermittent self-catheterization in 8, and ileal conduit urinary diversion in 5. A total of 14 patients were on renal replacement therapy before receiving the graft. Cyclosporine based triple therapy was administered to maintain immunosuppression in all cases and antithymocytic globulin was given for induction in 7. Results: Six grafts have failed, including 1 in a patient who underwent successful re-transplantation. Median graft survival was 7.23 years. Two patients died after graft nephrectomy. At a mean followup of 52.8 months (range 1 month to 14 years) 11 of 17 grafts are functioning with a mean serum creatinine of 112.7 ± 29.4 mmol./l. Conclusions: These data demonstrate the feasibility of cadaveric renal transplantation in patients with spina bifida and end stage renal failure. We currently recommend that these patients should not be deprived of the benefits of renal transplantation. References 1 : Follow-up of spina bifida children with and without upper renal tract changes at birth. Eur J Pediatr Surg1991; 1: 5. Crossref, Medline, Google Scholar 2 : The role of intraoperative heparin in cyclosporine treated cadaveric renal transplant recipients. J Urol1999; 162: 682. Link, Google Scholar 3 : The prognosis for end-stage renal failure in spinal cord injury and spina bifida: Australia and New Zealand, 1970–1991. Aust New Z J Med1994; 24: 36. 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Grunberg J, Rebori A and Verocay M (2020) Peritoneal Dialysis in Children with Spina Bifida and Ventriculoperitoneal Shunt: One Center'S Experience and Review of the LiteraturePeritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, 10.1177/089686080302300514, VOL. 23, NO. 5, (481-486), Online publication date: 1-Sep-2003. Müller T, Arbeiter K and Aufricht C (2002) Renal function in meningomyelocele: risk factors, chronic renal failure, renal replacement therapy and transplantationCurrent Opinion in Urology, 10.1097/00042307-200211000-00006, VOL. 12, NO. 6, (479-484), Online publication date: 1-Nov-2002. Volume 167Issue 2 Part 1February 2002Page: 477-479 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordskidney transplantationkidney failure, chronickidneyneural tube defectsdialysisMetricsAuthor Information RICHARD E. POWER More articles by this author KIARAN J. O'MALLEY More articles by this author DILLY M. LITTLE More articles by this author MARY G. DONOVAN More articles by this author TOM A. CREAGH More articles by this author DENIS M. MURPHY More articles by this author DAVID P. HICKEY More articles by this author Expand All Advertisement PDF downloadLoading ...