Marcou M, Apel H, Wullich B, Hirsch-Koch K. [Kidney transplantation in children with complex urogenital malformations-what should be considered?].
UROLOGIE (HEIDELBERG, GERMANY) 2024;
63:351-356. [PMID:
38324034 DOI:
10.1007/s00120-024-02289-4]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND
Congenital anomalies of the kidneys and urinary tract (CAKUT) are the most common cause of end-stage renal disease (ESRD) in children. Approximately one third of children with CAKUT have lower urinary tract dysfunction (LUTD).
AIM
This article highlights the important aspects that need to be considered in kidney transplantation of children with complex urogenital malformations.
MATERIALS AND METHODS
The paper reviews the existing literature regarding the evaluation, preparation, perioperative management, and follow-up of children with complex urogenital malformations and ESRD undergoing renal transplantation.
RESULTS
Comprehensive diagnostics are required before any pediatric kidney transplantation. If LUTD is suspected, voiding cystourethrography and a urodynamic examination should be performed. Treatment of symptomatic vesicoureterorenal reflux and LUTD is mandatory prior to pediatric kidney transplantation. Following successful kidney transplantation of children with congenital urogenital malformations, lifelong follow-up is required. Regular reevaluations of the bladder by means of urodynamic examinations are necessary. In patients following bladder augmentation with intestinal segments or urinary diversions in childhood, regular endoscopic examinations of the urinary tract are recommended to rule out secondary malignancy.
CONCLUSION
Treatment of children with complex urogenital malformations should be carried out in centers with appropriate expertise.
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