Kidney Transplantation

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Abstract
A grossly abnormal lower urinary tract has often been considered a contraindication to transplantation. Our studies indicate, however, that excellent results can be achieved with intestinal conduits when the bladder is irreparably damaged. Nine transplants were done in eight patients with intestinal conduits in our series of 300 consecutive transplants (incidence of 3%). Ages ranged from 8 to 45 years and five patients were 14 years of age. Renal failure was caused by lower urinary tract disease in all-cases. Seven donors were related to patients and two were cadaveric. There were two deaths, both unrelated to the conduit. The remaining six patients continue to do well with excellent kidney function one to five years after transplantation. Recurrent renal infection always signified partial ureteral obstruction, for which three patients required ureteral revision one to two years after transplantation. The conduits did not lead to any other complications. (JAMA229:534-537, 1974)

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