TY - JOUR
T1 - Diagnostic and therapeutic management of vesico-ureteral reflux in pediatric kidney transplantation-Results of an online survey on behalf of the European Society for Paediatric Nephrology
AU - Zirngibl, Matthias
AU - Buder, Kathrin
AU - Luithle, Tobias
AU - Tönshoff, Burkhard
AU - Weitz, Marcus
AU - Members of the “Transplantation Working Group” of the European Society for Paediatric Nephrology (ESPN)
AU - Alonso-Melgar, Ángel
AU - Ariceta, Gema
AU - Awan, Atif
AU - Bakkaloglu, Sevcan A.
AU - Baskin, Esra
AU - Bekassy, Zivile
AU - Bhimma, Rajendra
AU - Bitzan, Martin
AU - Bjerre, Anna Kristina
AU - Bootsma-Robroeks, Charlotte M.
AU - Bouts, Antonia
AU - Büscher, Anja
AU - Bulum, Burcu
AU - Christian, Martin
AU - Cicek, Neslihan
AU - Clothier, Joanna
AU - Cornelissen, Marlies
AU - Dehoux, Laurène
AU - Kılıç, Beltinge Demircioğlu
AU - Dinçel, Nida Temizkan
AU - Esfandiar, Nasrin
AU - Espinosa-Román, Laura
AU - Fila, Marc
AU - Galiano, Matthias
AU - Gander, Romy
AU - Gessner, Michaela
AU - Grenda, Ryszard
AU - Henne, Thomas
AU - Herthelius, Maria
AU - Goñi, Maria Herrero
AU - Higueras, Walter
AU - Hooman, Nakisa
AU - Jahnukainen, Timo
AU - Jankauskiene, Augustina
AU - de Jong, Huib
AU - Knops, Noël
AU - Konrad, Martin
AU - Levtchenko, Elena
AU - Madrid-Aris, Alvaro
AU - Marks, Stephen D.
AU - Mattoo, Tej K.
AU - Maxted, Andrew
AU - Melgosa-Hijosa, Marta
AU - Mincham, Christine Marie
AU - Mitsioni, Andromachi
N1 - Funding Information: Open Access funding enabled and organized by Projekt DEAL. Publisher Copyright: © 2022 The Authors. Pediatric Transplantation published by Wiley Periodicals LLC.
PY - 2023/3
Y1 - 2023/3
N2 - Background: Vesico-ureteral reflux (VUR) is considered to be a risk factor for recurrent febrile urinary tract infections and impaired renal transplant survival. Methods: An online survey supported by the European Society for Paediatric Nephrology was designed to evaluate current management strategies of VUR in native and transplanted kidneys of recipients aged <18 years. Results: Seventy-three pediatric transplant centers from 32 countries contributed to the survey. All centers performed urological evaluation prior to pediatric kidney transplantation (KTx) with subsequent interdisciplinary discussion. Screening for VUR in native kidneys (30% in all, 70% in selected patients) led to surgical intervention in 78% (11% in all, 89% in selected patients) with a decided preference of endoscopic intervention over ureterocystoneostomy. Following KTx, continuous antibiotic prophylaxis was applied in 65% of the patients and screening for allograft VUR performed in 93% of selected patients. The main management strategies of symptomatic allograft VUR were continuous antibiotic prophylaxis (83%) and surgical treatment (74%) (endoscopic intervention 55%, redo ureterocystoneostomy 26%). Conclusions: This survey demonstrates the high variability in the management of VUR in pediatric KTx recipients, points to knowledge gaps, and might serve as a starting point for improving the care for patients with VUR in native and transplanted kidneys.
AB - Background: Vesico-ureteral reflux (VUR) is considered to be a risk factor for recurrent febrile urinary tract infections and impaired renal transplant survival. Methods: An online survey supported by the European Society for Paediatric Nephrology was designed to evaluate current management strategies of VUR in native and transplanted kidneys of recipients aged <18 years. Results: Seventy-three pediatric transplant centers from 32 countries contributed to the survey. All centers performed urological evaluation prior to pediatric kidney transplantation (KTx) with subsequent interdisciplinary discussion. Screening for VUR in native kidneys (30% in all, 70% in selected patients) led to surgical intervention in 78% (11% in all, 89% in selected patients) with a decided preference of endoscopic intervention over ureterocystoneostomy. Following KTx, continuous antibiotic prophylaxis was applied in 65% of the patients and screening for allograft VUR performed in 93% of selected patients. The main management strategies of symptomatic allograft VUR were continuous antibiotic prophylaxis (83%) and surgical treatment (74%) (endoscopic intervention 55%, redo ureterocystoneostomy 26%). Conclusions: This survey demonstrates the high variability in the management of VUR in pediatric KTx recipients, points to knowledge gaps, and might serve as a starting point for improving the care for patients with VUR in native and transplanted kidneys.
KW - febrile urinary tract infection
KW - online survey
KW - pediatric kidney transplantation
KW - therapy
KW - ureteral implantation
KW - vesico-ureteral reflux
UR - http://www.scopus.com/inward/record.url?scp=85144062886&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/petr.14449
DO - https://doi.org/10.1111/petr.14449
M3 - Article
C2 - 36478499
SN - 1397-3142
VL - 27
SP - e14449
JO - Pediatric transplantation
JF - Pediatric transplantation
IS - 2
M1 - e14449
ER -