Abstract
Due to atrophic bladder, patients undergoing long-term dialysis experience vesicoureteral reflux and complicated urinary tract infections after kidney transplantation. A 58-year-old woman underwent living donor kidney transplantation after 41 years of dialysis. She had no contraindications, with good cardiac function and minimal artery calcification despite the long history of hemodialysis. Immunosuppression was initiated with tacrolimus, mycophenolate mofetil, prednisolone, and basiliximab. Ureteroneocystostomy with an antireflux technique was carefully conducted as her bladder volume was 15 mL. The postoperative clinical course was uneventful with immediate graft function. The bladder volume gradually increased to 81 mL at discharge, 3 weeks postoperatively. The patient was initially depressed due to frequent urination early post-transplant but recovered soon after as the bladder volume gradually increased to 400 mL. The patient has not yet reported a urinary tract infection episode. This case highlights living donor kidney transplantation-induced recovery of bladder function with careful ureteroneocystostomy, despite the long dialysis history.
Highlights
Academic Editor: Pasquale EspositoKidney transplantation is the preferred treatment for patients with end-stage renal diseases [1]
Patients are susceptible to urinary complications due to atrophic bladder [8,9,10], and dialysis for more than 10 years was found to negatively impact short-term graft survival [11]
A 58-year-old woman on hemodialysis for 41 years and 11 months was referred to our hospital for a living donor kidney transplantation from her husband’s sister
Summary
Kidney transplantation is the preferred treatment for patients with end-stage renal diseases [1]. In Japan, the number of kidney donations after brain death has increased only slightly, forcing many patients into long-term dialysis [2]. Kidney transplantation for long-term dialysis patients is safe [3,4,5,6,7]. Patients are susceptible to urinary complications due to atrophic bladder [8,9,10], and dialysis for more than 10 years was found to negatively impact short-term graft survival [11]. We report a living donor kidney transplantation case after 41 years of hemodialysis. This dialysis period before transplantation may be the longest in the world. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
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