En Bloc Simultaneous Liver-Kidney Transplantation Compared to the Traditional Technique: Results From a Single Center.

Background: Simultaneous liver-kidney transplantation is indicated for patients with concomitant end-stage liver disease and end-stage renal disease. The traditional technique involves separate implantations of the liver and the kidney. In the en bloc approach, the liver is recovered en bloc with the right kidney and the donor renal artery is anastomosed to the donor splenic artery.

BLADDER TRANSPLANTATION: THE NEW FRONTIER IN ABDOMINAL ORGAN TRANSPLANTATION.

Lower urinary tract abnormalities are directly implicated in the etiology of renal dysfunction in 6 to 24% of dialytic patients. These patients require bladder capacity and compliance readjustment before being considered viable candidates for renal transplantation. Vesical augmentation surgeries often involve the use of intestinal segments.

Outcomes of endovascular treatment of renal arterial stenosis in transplanted kidneys.

Objective: To evaluate the effectiveness and outcomes of endovascular treatment of TRAS with PTA.

Materials And Methods: We searched our prospectively collected database looking at cases of TRAS between January 2005-December 2011. CCT was the gold-standart for diagnosis of TRAS.

Urologic issues in pediatric transplant recipients.

The limited supply of kidneys for pediatric transplantation leads to a large number of children in waiting transplant list. These patients have to be properly evaluated and prepared before organ transplantation to increase its success. The aim of this review is focus on urologic issues of pediatric kidney transplants such as preoperative evaluation and urinary tract abnormalities correction, surgical technique, and postoperative complications.

Low-intensity shockwave therapy for erectile dysfunction in kidney transplant recipients. A prospective, randomized, double blinded, sham-controlled study with evaluation by penile Doppler ultrasonography.

Objectives: To study the efficacy of Low intensity Extracorporeal Shockwave Therapy (Li- ESWT) for the treatment of erectile dysfunction (ED) in kidney transplanted men.

Methods: Twenty men (mean age = 53.7 years) were selected.

Does the urinary tract infection caused by carbapenem-resistant Gram-negative bacilli impact the outcome of kidney transplant recipients?

The incidence of urinary tract infection (UTI) after kidney transplantation (KT) caused by multidrug-resistant (MDR) bacteria is growing. The aim of this study was to analyze the impact of UTI caused by carbapenem-resistant Gram-negative bacteria (CR-GNB) in the survival of graft and recipients following KT. This was a retrospective cohort study involving patients who underwent KT between 2013 and 2016.

Outbreak of IMP-producing carbapenem-resistant Enterobacter gergoviae among kidney transplant recipients.

Objectives: The objective of this study was to investigate a prolonged outbreak of carbapenem-resistant Enterobacter gergoviae (CREG) involving kidney transplant recipients (KTRs) between 2009 and 2014.

Methods: A case-control study was undertaken. Controls (n = 52) were selected from CREG-negative KTRs.

Urological complications, vesicoureteral reflux, and long-term graft survival rate after pediatric kidney transplantation.

To describe a single-center experience with kidney transplantation and then study some donor and recipient features that may impact on graft survival and urological complication rates. We reviewed our database searching for pediatric patients who underwent kidney transplantation from August 1985 through November 2012. Preoperative data and postoperative complications were recorded.

Amikacin prophylaxis and risk factors for surgical site infection after kidney transplantation.

Background: Antibiotic prophylaxis plays a major role in preventing surgical site infections (SSIs). This study aimed to evaluate antibiotic prophylaxis in kidney transplantation and identify risk factors for SSIs.

Methods: We evaluated all kidney transplantation recipients from January 2009 and December 2012.

Revascularization of living-donor kidney transplant with multiple arteries: long-term outcomes using the inferior epigastric artery.

Objective: To study the safety and long-term outcomes of use of the inferior epigastric artery (IEA) for revascularization of small accessory kidney arteries (3 mm or less).

Materials And Methods: Data of 602 living-donor kidney transplants were reviewed. Age was 37.

Caliceal-cutaneous fistula after kidney transplantation.

Urinary fistula is a one of the most common complications after kidney transplantation. Conservative treatment with stent and Foley catheter drainage may be tried, however in some cases more invasive approach is needed. Caliceal fistula is a rare condition and the diagnosis may be missed.

Histologic inflammatory changes on the prostatic gland due to immunosuppression for kidney transplantation.

Objective: To determine the incidence of type IV prostatitis in patients with kidney transplantation receiving an immunosuppression regimen and to compare it with that of a nonimmunosuppressed control group.

Methods: We retrospectively reviewed 216 electronic charts of patients who had undergone surgical treatment for benign prostatic hyperplasia from August 2000 to January 2006. Of the 216 patients, 183 did not receive immunosuppressive therapy and were included in the control group (group 1).

Comparison between laparoscopic and subcostal mini-incision for live donor nephrectomy.

Objectives: The aim of this study was to compare the results of laparoscopic donor nephrectomy with open donor nephrectomy.

Methods: A non-randomized prospective analysis was conducted of living donor kidney transplantations (118 open donor nephrectomies; 57 laparoscopic donor nephrectomies) between January 2005 and December 2007 in the Kidney Transplantation Unit of Hospital das Clínicas of Faculdade de Medicina of the Universidade de São Paulo.

Results: Mean donor operative time, mean donor hospital stay, mean postoperative creatinine values, and rates of complications and graft survival were similar for both groups.

Use of inverted fluoroscope's C-arm during endoscopic treatment of urinary tract obstruction in pregnancy: a practicable solution to cut radiation.

Objectives: To describe the use of pulsed fluoroscopic guidance, to perform endoscopic procedures in pregnant women, by inverting the fluoroscope's c-arm using a lead thyroid collar to shield the fetus from the direct X-ray beam. The use of radiation during treatment of pregnant patients with urolithiasis remains a recurring dilemma.

Methods: Between May 2006 and December 2008, endoscopic treatment due to ureteral stones was attempted in 8 pregnant women.

Transurethral injection therapy with carbon-coated beads (Durasphere®) for treatment of recurrent pyelonephritis in kidney transplant patients with vesico-ureteral reflux to the allograft.

Introduction And Objectives: Recurrent transplant pyelonephritis (RTP) secondary to vesico-ureteral reflux (VUR) to the transplant kidney (KTx) remains a significant cause of infectious complications with impact on patient and graft outcomes. Our objective was to verify the safety and efficacy of transurethral injection of Durasphere(®) to relieve RTP secondary to VUR after renal transplantation.

Patients And Methods: Between June 2004 and July 2008, eight patients with RTP (defined as two or more episodes of pyelonephritis after transplantation) and VUR to the KTx were treated with subureteral injections of Durasphere(®).

Ureteral fibroepithelial polyps in a pregnant woman: case report.

Context: Ureteral fibroepithelial polyps are rare benign nonepithelial tumors, and less than 200 cases have been reported in the literature. We report on a pregnant patient with ureteral fibroepithelial polyps that were successfully treated with laparotomy.

Case Report: A 23-year-old pregnant woman presented with a three-month history of intermittent lumbar pain of low intensity.

Incidence of histological prostatitis and its correlation with PSA density.

Objective: The aim of this study was to determine the incidence of asymptomatic, histologically proven prostatitis in men with symptoms of benign prostate hyperplasia and to observe the correlation between asymptomatic prostatitis and prostate specific antigen (PSA) density.

Introduction: The incidence of type IV prostatitis is unknown. There is a tendency to correlate the presence of inflammatory prostatitis with an elevation of PSA.

Case report: late recurrent hematuria following laparoscopic radical prostatectomy may predict internal pudendal artery pseudoaneurysm and arteriovenous fistula.

We report two cases of a pseudoaneurysm of the internal pudendal artery with arteriovenous fistula after extraperitoneal laparoscopic radical prostatectomy. The clinical presentation was delayed recurrent hematuria and urinary retention that necessitated bladder clot evacuation. Subsequent arteriography detected the vascular abnormality and a superselective embolization was performed.

Comparative and prospective analysis of three different approaches for live-donor nephrectomy.

Purpose: Living donor nephrectomy is usually performed by a retroperitoneal flank incision. Due to the significant morbidity and long recovery time for a flank incision, anterior extra peritoneal sub-costal and transperitoneal video-laparoscopic methods have been described for donor nephrectomy. We prospectively compare the long-term results of donors as well as functional recipients submitted to these three approaches.

Radical retropubic prostatectomy for localized prostate cancer in renal transplant patients.

Objective: To investigate the feasibility of radical retropubic prostatectomy (RRP) in renal transplant recipients with clinically localized prostate cancer.

Methods: A prospective protocol was established between August 2004 and November 2007. In that period, 8 patients diagnosed with localized prostate cancer were submitted to RRP, and their clinicopathologic data were reviewed.

Comparison of renal transplantation outcomes in children with and without bladder dysfunction. A customized approach equals the difference.

Purpose: We examined the development of urological abnormalities in a group of pediatric renal transplant recipients.

Materials And Methods: We reviewed 211 patients younger than 19 years who underwent 226 renal transplants. Three groups of patients were studied-136 children with end stage renal disease due to a nonurological cause (group 1), 56 children with a urological disorder but with an adequate bladder (group 2a) and 19 children with lower urinary tract dysfunction and/or inadequate bladder drainage (group 2b).

Primary reconstruction is a good option in the treatment of urinary fistula after kidney transplantation.

Objectives: urinary fistula is a morbid complication after renal transplantation leading to graft losses and patient death. We review and update our data on urinary fistula after renal transplantation and the outcome after surgical and conservative management.

Materials And Methods: the charts of 1046 renal transplants were reviewed.

Is polypropylene mesh safe and effective for repairing infected incisional hernia in renal transplant recipients?

Introduction: Infected incisional hernias are common in kidney transplant patients. Treating them in immunosuppressed patients can take months, increasing costs and implying loss of working productivity. Abdominal wall prostheses have not been used in infected immunosuppressed patients because of poor infection control.