Long-term outcome of pediatric renal transplantation in boys with posterior urethral valves

To determine whether there is a difference in the outcome of renal transplantation (RT) in patients with posterior urethral valves (PUV) and children with non-uropathy related end stage renal disease.

Data were acquired retrospectively. We analyzed possible factors that influence the function of renal allografts and graft survival. Between 1995 and 2016 there were 149 RT. Out of them, there were 27 boys with PUV, who received 29 kidneys. Thirty patients, who received a total of 31 renal grafts due to a non-uropathic (NU) diagnosis, served as control group. Mean follow-up was 7.4 to 10.2 years.

There was no difference in estimated graft survival between patients with PUV and NU patients. Graft failure occurred in 23.1% of PUV patients and 34.5% patients of the NU group. There was no statistically significant disparity in graft function between the two groups. Age at transplantation and donor age were the only factors that had a significant impact on renal function. There was a higher incidence of UTI in the PUV group (96%) than in the NU group (67%). Vesicostomy was the favourable intervention in regards of graft function.

RT in PUV patients is successful with the same outcome as in NU patients. Bladder dysfunction may not have a major impact on graft function and graft survival. It seems that the type of pre-transplant surgical procedures may influence outcome. Therefore, these interventions -if necessary- should be limited to a minimum.

Retrospective Comparative Study LEVEL OF EVIDENCE: Level III.

Journal of pediatric surgery. 2018 Jul 06 [Epub ahead of print]

Doris Hebenstreit, Dagmar Csaicsich, Karin Hebenstreit, Thomas Müller-Sacherer, Gabriela Berlakovich, Alexander Springer

Department of Urology, Medical University Innsbruck, Austria., Department of Pediatrics, Medical University Vienna, Austria., Medical University Vienna, Austria., Division of Transplant Surgery, Department of Surgery, Medical University Vienna, Austria., Division of Pediatric Surgery, Department of Surgery, Medical University Vienna, Austria. Electronic address: .