LONG-TERM RESULTS OF RENAL-TRANSPLANTATION INTO THE VALVE BLADDER

Between 1970 and 1990 renal transplantation was performed in 16 patien ts with a history of posterior urethral valves. While 10 patients had undergone supravesical urinary diversion before the development of end stage renal disease, all but 1 transplant were drained to the unaugme nted native bladder. The 2 and 5-year graft survival rates were 70% an d 59%, respectively. Of the 15 surviving patients 11 have allografts t hat are functioning at a mean of 86 months after transplantation with a mean serum creatinine of 2.0 mg./dl. Urological complications occurr ed in 19% of the transplants. No detrimental effect of the valve bladd er on long-term allograft survival or function was apparent. With appr opriate treatment of vesical dysfunction, these patients can be expect ed to have graft function comparable to the general transplant populat ion despite use of the unaugmented native bladder.