Pretransplant Endoscopic Management of Vesicoureteral Reflux in Native Kidneys

Introduction: Vesicoureteral reflux (VUR) into native kidneys is a common condition in children and adolescents undergoing kidney transplantation (KTx). There exists conflicting data regarding the long-term impact of VUR in pediatric KTx recipients for both native and allograft kidneys. We report on our experience with pretransplant endoscopic antireflux procedure for native kidneys in children planned for KTx. Materials and Methods: We retrospectively reviewed our hospital inpatient and outpatient records of all children (≤18 years of age) who have undergone renal transplantation at our hospital. Patient demographics were noted for further analysis. Posttransplant creatinine, imaging records, and treatment were similarly assessed and noted. Posttransplant creatinine, imaging records, and treatment were similarly assessed and noted. Results: During the study period, a total of 21 children ≤18 years of age underwent renal transplantation at our center. Seven of these children who had VUR affecting the native kidneys on preoperative evaluation underwent endoscopic antireflux procedure. On confirming the absence of VUR on voiding cystourethrogram 6 weeks later, the children underwent KTx. All these 7 children have had a minimum of 5-year follow-up, and during this period, they have had no evidence of pyuria and bacteriuria. Conclusions: Pretransplant endoscopic antireflux procedure for VUR of native kidneys is a safe, simple, and reliable intervention to help in the prevention of urinary tract infection and acute pyelonephritis in the post-KTx period.