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Renal transplantation in patients with an augmentation cystoplasty

대한이식학회지 2020년 34권 4호 p.238 ~ 243
최진선, 고현민, 김효기, Chung Chris, 한아람, 민승기, 하종원, 민상일,
소속 상세정보
최진선 ( Choi Jin-Sun ) - Seoul National University College of Medicine Department of Surgery
고현민 ( Ko Hyun-Min ) - Seoul National University College of Medicine Department of Surgery
김효기 ( Kim Hyo-Kee ) - Seoul National University College of Medicine Department of Surgery
 ( Chung Chris ) - Seoul National University College of Medicine Department of Surgery
한아람 ( Han Ah-Ram ) - Seoul National University Hospital Department of Surgery
민승기 ( Min Seung-Kee ) - Seoul National University Hospital Department of Surgery
하종원 ( Ha Jong-Won ) - Seoul National University College of Medicine Department of Surgery
민상일 ( Min Sang-Il ) - Seoul National University College of Medicine Department of Surgery

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 urgical 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.

키워드

Kidney transplantation; Bladder augmentation; Cystoplasty

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