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Orthotopic ileal neobladder reconstruction in patients with recurring bladder cancer after renal transplantation – a report of two cases and a review of the literature
Author(s) -
Wang Jianwen,
Xing Nianzeng,
Zhang Xiaodong,
Yan Yong,
Zhang Junhui,
Li Xiaobei,
Zhang Weili,
Guan Delin
Publication year - 2009
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2009.00988.x
Subject(s) - medicine , cystectomy , bladder cancer , urology , transplantation , urinary diversion , urinary system , immunosuppression , renal function , surgery , kidney transplantation , hydronephrosis , urinary bladder , kidney , cancer
Renal transplant recipients have a high risk of developing multiple and invasive urothelial tumors because of long‐term immunosuppression and infections with oncogenic viruses in China. However, treatment of renal transplant recipients who developed invasive bladder tumor is challenging. We aimed to evaluate the efficacy and safety of orthotopic ileal neobladder reconstruction following radical cystectomy in renal transplant recipients. Orthotopic ileal neobladder reconstruction and preservation of the transplanted kidney were performed in two patients after one and 36 months of transplantation, respectively. One recipient was lacking a bladder because of prior cystectomy before the transplantation, and the other developed multiple and invasive bladder cancer after the transplantation. During the 14‐month and seven‐yr follow‐up postoperation, no serious complications occurred except slight hydronephrosis in one patient. No rejection and graft dysfunction occurred in both patients with reduced dosage of immunosuppressants, and serum creatinine as a marker of renal function remained stable. Urinary continence was satisfactory during the day and night with voluntary voiding. Our experience showed that radical cystectomy and orthotopic ileal neobladder reconstruction in transplant patients with stable renal function is a safe and effective way to provide better quality of life, satisfactory urinary diversion and preservation of renal function simultaneously.