MP79-15 UROLOGICAL COMPLICATIONS IN PEDIATRIC PATIENTS UNDERGOING RENAL TRANSPLANTATION

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery I1 Apr 2015MP79-15 UROLOGICAL COMPLICATIONS IN PEDIATRIC PATIENTS UNDERGOING RENAL TRANSPLANTATION Irina Stanasel, Cagatay Afsarlar, Hoang Lee, Abhishek Seth, Chester Koh, Patricio Gargollo, Edmond Gonzales, David Roth, and Nicolette Janzen Irina StanaselIrina Stanasel More articles by this author , Cagatay AfsarlarCagatay Afsarlar More articles by this author , Hoang LeeHoang Lee More articles by this author , Abhishek SethAbhishek Seth More articles by this author , Chester KohChester Koh More articles by this author , Patricio GargolloPatricio Gargollo More articles by this author , Edmond GonzalesEdmond Gonzales More articles by this author , David RothDavid Roth More articles by this author , and Nicolette JanzenNicolette Janzen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2872AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal transplantation is the management of choice for children with end stage renal disease (ESRD). We performed a retrospective analysis of patients undergoing renal transplantation at a children's hospital in order to evaluate the prevalence and type of urological complications in this patient population. METHODS A retrospective chart review of 100 consecutive children who underwent renal transplantation at a children's hospital between January 2009 and April 2014 was performed. Forty three females and 57 males were identified. The cohort included 37 children who underwent renal transplantation from a living related donor and 63 children who had a renal graft from a deceased donor. The average age at time of transplant was 14.04 years. Twenty six of the 100 children reviewed had a urological etiology for ESRD (posterior or anterior urethral valves, reflux nephropathy, Prune Belly Syndrome, or neurogenic bladder.) All children had a non-refluxing anastomosis performed by either the pediatric transplant surgeon (78) or a consulting pediatric urologist (22.) Four children had a ureteral stent placed at time of reimplantation. RESULTS Children who experienced renal complications were younger at time of renal transplantation, with an average age of 10.5 vs 14.04 years. Postoperatively, all patients underwent follow up with ultrasonography. If hydronephrosis was demonstrated on ultrasound or if the patients developed a urinary tract infection (UTI), patients also underwent a voiding cystourethrogram (VCUG). In cases of suspected obstruction, a MAG-3 renogram was performed. These outcomes are detailed in Figure 1. Twenty six children had a urological reason for ESRD, 11 of whom (42%) developed a urological complication. Of 74 patients without a urological reason for ESRD, 18 (24%) developed urological complications (p=0.13). CONCLUSIONS Children with urological reason for ESRD trend toward having more urological complications. We observed an overall low rate (29%) of urological complications. Although when patients had a UTI a VCUG detected reflux in 15 of 23 patients (65%), our data suggests that performing a VCUG for all transplant patients is unnecessary, and one can be performed if the patient demonstrates hydronephrosis or develops a UTI post-operatively. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e1016 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Irina Stanasel More articles by this author Cagatay Afsarlar More articles by this author Hoang Lee More articles by this author Abhishek Seth More articles by this author Chester Koh More articles by this author Patricio Gargollo More articles by this author Edmond Gonzales More articles by this author David Roth More articles by this author Nicolette Janzen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...