RENAL-TRANSPLANTATION IN PATIENTS WITH AB NORMALITIES OF THE LOWER URINARY-TRACT

In the transplant centre in Erlangen-Nuremberg, 1232 patients underwen t renal transplantation between 1966 and 1993. In 4.5% of cases (56 pa tients) the renal end stage disease had been caused by severe abnormal ities or functional disturbance of the lower urinary tract. Despite lo ngstanding defunctionalization, urinary diversions and multiple operat ive procedures, it was possible to use the original bladder for ureter ocystoneostomy in all pa tients. Only 1 patient needed an enterocystop lasty after transplantation. Altogether 72 transplantations have been performed in 56 patients ranging from 10.2 to 62.7 years of age. At fo llow up, 40 patients (71%) had a functioning graft with a mean serum c reatinin level of 1.5 mg%. The 5-year transplant survival rate is 57.3 %. Our results suggest that carefully planned renal transplantation in urological patients has results comparable to those obtained in other , non-risk, kidney transplant recipients. The methods of bladder recon struction and augmentation, intermittent self-catheterization as well as anticholinergics and continuous antibiotic prophylaxis combine to m ake the ileal or colonic conduits needed earlier unnecessary.