| Autor: |
Zirngibl, Matthias, Weitz, Marcus, Luithle, Tobias, Tönshoff, Burkhard, Nadalin, Silvio, Buder, Kathrin, Aßfalg, Volker, Baccarani, Umberto, Beldi, Guido, Blanc, Thomas, Burkert, Jan, Desender, Liesbeth, Detry, Olivier, Ektov, Denis, Ferraresso, Mariano, Fischer, Lutz, García‐Aparicio, Luís, Garnier, Sarah, de Gier, Robert PE, van Heurn, Ernst WE |
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| Zdroj: |
Pediatric Transplantation; Feb2024, Vol. 28 Issue 1, p1-14, 14p |
| Abstrakt: |
Background: Vesicoureteral reflux (VUR) is common in children and adolescents undergoing kidney transplantation (KTx) and may adversely affect allograft kidney function. Methods: To explore the current management of symptomatic native and allograft VUR in pediatric KTx recipients, an online survey was distributed to European surgical transplant professionals. Results: Surgeons from 40 pediatric KTx centers in 18 countries participated in this survey. Symptomatic native kidney VUR was treated before or during KTx by 68% of the centers (all/selected patients: 33%/67%; before/during KTx: 89%/11%), with a preference for endoscopic treatment (59%). At KTx, 90% favored an anti‐reflux ureteral reimplantation procedure (extravesical/transvesical approach: 92%/8%; preferred extravesical technique: Lich‐Gregoir [85%]). Management strategies for symptomatic allograft VUR included surgical repair (90%), continuous antibiotic prophylaxis (51%), bladder training (49%), or noninterventional surveillance (21%). Redo ureteral implantation and endoscopic intervention for allograft VUR were equally reported (51%/49%). Conclusions: This survey shows uniformity in some surgical aspects of the pediatric KTx procedure. However, with regard to VUR, there is a significant variation in practice patterns that need to be addressed by future well‐designed and prospective studies. In this way, more robust data could be translated into consensus guidelines for a more standardized and evidence‐based management of this common condition in pediatric KTx. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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