PD22-05 RENAL TRANSPLANTATION INTO URINARY DIVERSIONS AND RECONSTRUCTED BLADDERS

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery I (PD22)1 Apr 2020PD22-05 RENAL TRANSPLANTATION INTO URINARY DIVERSIONS AND RECONSTRUCTED BLADDERS James Chong*, Rhana Hassan Zakri, Muhammad Shamim Khan, C Geoff Koffman, Nizam Mamode, and Jonathon Olsburgh James Chong*James Chong* More articles by this author , Rhana Hassan ZakriRhana Hassan Zakri More articles by this author , Muhammad Shamim KhanMuhammad Shamim Khan More articles by this author , C Geoff KoffmanC Geoff Koffman More articles by this author , Nizam MamodeNizam Mamode More articles by this author , and Jonathon OlsburghJonathon Olsburgh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000872.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal failure secondary to urological disorders can necessitate urinary diversion or reconstruction either pre or post-kidney transplant. Decision-making regarding timing of diversion/reconstruction may be affected by living (LD) or deceased (DD) donor options. We assessed our kidney transplant outcomes into urinary diversions and reconstructed bladders. METHODS: Single-centre retrospective review of kidney transplants between 1986-2019. Graft and patient survival were calculated, and compared to our general transplant population. RESULTS: 87 patients (mean age 38.2) who had 97 transplants required urinary diversion or reconstruction. 80 of 97 were first transplants. Mean follow-up was 141 months. Cutaneous ureterostomy (CU): 18 transplants (8 LD; 10 DD); 16 CU formed at time of transplant. 1 patient required two sequential transplants; first was diverted to CU 3 years after transplant (for unrecognised neuropathic bladder), the second a planned CU. The other CU was formed 4 years post-transplant for a radiotherapy vesico-vaginal fistula from cervical cancer. Pre-formed ileal conduit (IC): 15 transplants into pre-formed IC (7 LD; 8 DD). 7 of 15 died during follow-up, 4 of 7 with functioning transplant in-situ. Post-transplant IC: 7 transplants into bladder (2 LD; 5 DD) but subsequent IC diversion (5 due to bladder cancer, 1 due to worsening bladder function from spina bifida and 1 from recurrent urosepsis). Reconstructed urinary tract: 57 transplants into augmented bladders using native ureter (4), gastric-segment (1), ileo-caecum (7) and ileum (45). 13 were augmented post-transplant; 2 were undiverted into neo-bladders post-transplant. CONCLUSIONS: Transplantation into urinary diversions and reconstructed bladders appears safe, with similar graft and patient survival to our general transplant population. There has been a significant increase in planned living donor transplant for patients with complex urinary tracts. DD kidney recipients with unsafe bladders may require initial CU before undiversion and reconstruction to prevent complications from a “dry” augment. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e460-e461 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information James Chong* More articles by this author Rhana Hassan Zakri More articles by this author Muhammad Shamim Khan More articles by this author C Geoff Koffman More articles by this author Nizam Mamode More articles by this author Jonathon Olsburgh More articles by this author Expand All Advertisement PDF downloadLoading ...