Not many year
s ago, children with
structural or functional abnormalitie
s of the lower urinary tract were con
sidered to be very high-ri
sk recipient
s and were denied renal tran
splant (RT). However, the development of novel
surgical recon
structive technique
s (eg, augmentation cy
stopla
sty, Mitrofanoff and Monti technique
s) ha
s improved the
se RT outcome for the
se patient
s. Neverthele
ss,
some concern
s have been rai
sed that bladder augmentation in the
se patient
s may increa
se the ri
sk of complication
s, predominantly urinary tract infection
s (UTI
s), urologic complication
s, bladder cancer, and allograft dy
sfunction and lo
ss. However, the higher incidence of UTI
s in the
se patient
s i
s more related to clean intermittent catheterization noncompliance or ve
sicoureteral reflux to the native kidney or graft than to the augmented bladder it
self and u
sually doe
s not lead to impairment of graft function. De
spite the
se po
ssible complication
s and the fact that our current knowledge i
s ba
sed on
studie
s with limited number
s of patient
s, children who have undergone recon
structive
surgerie
s can be tran
splanted with an outcome in graft function and
survival that i
s similar to tho
se with normal bladder
s.
sSec_2">Patient summary
spar0010">Despite possible complications and the fact that our current knowledge is based on studies with limited numbers of patients, children who have undergone reconstructive surgeries for structural or functional abnormalities of the lower urinary tract can be transplanted with an outcome in graft function and survival similar to those with normal bladders.