Recoverability of Bladder Function in Patients With Defunctionalized Bladder and Live-Donor Kidney Transplantation

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2024-12-01 DOI:10.1016/j.transproceed.2024.10.033

Bassem S. Wadie, Ahmed S. El Hefnawy, Ayman F. Refaie

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引用次数: 0

Abstract

Background

The purpose of this article was to assess the recoverability of bladder, in a subset of patients with uremia, planned for live-donor kidney transplantation.

Methods

Patients referred to the Voiding Dysfunction Unit for evaluation, prior to transplantation, were included in this study during the period 2004 to 2008 in a single institution with a track record in live-donor transplantation. Defunctionalized bladder was defined as patients with complete anuria or oliguria for at least 6 months. All had stage 5 end-stage renal disease (ESRD) and were subjected to invasive urodynamics prior and 6 months after live-donor kidney transplantation. Outcome measurement and statistical method: improvement of urodynamic variables after transplantation was the principal outcome measure. Comparisons were made using the one-sample two-tailed t test. One way analysis of variance was used for comparison of continuous variables and Pearson's Correlation coefficient for studying the correlation between the duration of anuria and different continuous variables.

Results

Thirty-two patients were included in this study. The bladder underwent a significant decline of its capacity with defunctionalization with a mean cystometric capacity at baseline of 253 ± 171 mL that increased to 389 (P = .001), compliance increased from 26 to 33 (P = .001), filling pressure decreased by 12 cm H20 (P = .001) and free maximum flow rate (Q max) increased from 13 to 16 mL/s (P = .007). Detrusor overactivity decreased in prevalence (from 26 to 14 cases) and amplitude (from 21 to 12 cm H20). Our study lacks voiding cystometry variables as well as in having diverse causes for defunctionalization.

Conclusions

After transplantation, urodynamic parameters significantly improved. With caution, these defunctionalized bladders (DBs) could be utilized for live-donor transplants with favorable functional outcome.

查看原文本刊更多论文

膀胱功能失活及活体肾移植患者膀胱功能的恢复。

背景：这篇文章的目的是评估尿毒症患者膀胱的恢复能力，计划进行活体肾移植。方法：在2004年至2008年期间，在同一家有活体供体移植记录的机构中，移植前向排尿功能障碍单元进行评估的患者被纳入本研究。膀胱功能障碍定义为患者完全无尿或少尿至少6个月。所有患者均患有5期终末期肾病（ESRD），并在活体肾移植前和移植后6个月接受有创尿动力学检查。结果测量和统计方法：移植后尿动力学指标的改善是主要的结果测量。采用单样本双尾t检验进行比较。采用单因素方差分析比较连续变量，Pearson相关系数研究无尿持续时间与不同连续变量的相关性。结果：本研究纳入32例患者。膀胱功能失能导致膀胱容量显著下降，膀胱容量从基线的253±171 mL增加到389 mL (P = 0.001)，膀胱顺应性从26 mL增加到33 mL (P = 0.001)，充注压力减少了12 cm H20 (P = 0.001)，自由最大流量（Q max）从13 mL/s增加到16 mL/s （P = 0.007）。逼尿肌过度活动的发生率（从26例降至14例）和幅度（从21至12 cm H20）下降。我们的研究缺乏排尿膀胱测量变量，以及有多种原因的去功能化。结论：移植后尿动力学参数明显改善。值得注意的是，这些失功能膀胱（DBs）可用于活体供体移植，具有良好的功能预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.