신장 이식후 방광요관역류: 요로 감염과 위험도

Abstract

Vesicoureteric reflux into the transplanted kidney has been described, but in general it has been disregarded and is not mentioned as a complication in recent reviews. But it may be harmful to the renal function in the long-term and has high incidence of symptomatic pyelonephritis with urinary tract infection in other studies. We studied prospectively 37 patients, who received living renal transplantation without complete antireflux surgery, out of 45 patients during the period from June 1991 to September 1992. Voiding cystourethrogram and urine culture were obtained all least once in 37 of 45 patients (82.2%) and serum BUN/creatinine and urinalysis were checked following surgery, weekly. These patients did not demonstrate an increased incidence of reflux, urinary tract infection or abnormalities of renal function. We conclude that a simple direct implantation of a normal ureter into a normal bladder is safe and should be considered the procedure of choice in renal transplantation and recommend that all functioning transplants be studied at yearly intervals with an IVP and VCUG to determine the true incidence of urologic complications. Key word : Vesicoureteric reflux, Renal transplantation, Urinary tract infection.