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Objectives: The objective of this study was to evaluate the effect of bilateral nephrectomy on posttransplantation urinary tract infection (UTI) among patients with end-stage renal disease (ESRD) due to autosomal dominant polycystic kidney disease (ADPKD)., Methods: In a retrospective case-control design, 62 patients with ESRD with ADPKD were divided into 2 groups: (A) 24 patients who underwent bilateral nephrectomies, and (B) 38 patients in whom bilateral nephrectomies had not been done. Pretransplantation and posttransplantation urine cultures were evaluated for UTI., Results: Sixty-two patients with ESRD with ADPKD were enrolled in this study. The average age was 42 years (range, 6-60 years). Forty patients (64.5%) were male and 22 (35.5%) were female. The mean duration of hemodialysis was 24 months (range, 2-120 months), which was the same for both groups. Bilateral nephrectomies were done for 24 participants (38.7%). There were 38 patients (61.3%) in group B who did not have the operation. UTI occurred in 23 patients (37.1%): 6 patients (25%) in group A and 17 patients (44.7%) in group B. The incidence of UTI was not statistically different between the 2 groups (P>.05). Furthermore, no relationship was found between age, gender, blood group, and UTI in patients with ADPKD (P>.05)., Conclusion: According to our study, the presence of large nonfunctional kidneys is not a risk factor for posttransplantation UTI in patients with ADPKD and ESRD.

The present study is a report of long-term results of the first 1200 operations from December 1988 to December 2003. Graft and patient survival rates in eligible cases were computed with Kaplan-Meier analysis. Recipients were 808 men, 392 women of mean age 33.6 +/- 12.5 years. Eighty six percent of cases used organs from living donors (40% related, 41% unrelated, and 5% spouses) and 14% from cadaveric source. The most common causes of end-stage renal disease were chronic glomerulonephritis (18.2%); reflux nephropathy (13.4%); and diabetic nephropathy (10.1%). Among 215 (17.9%) patients, 156 patients (13%) died in the posttransplant period. Most common causes of death were cardiovascular (28.3%), graft loss (20.7%), and infections (19.6%). The 1- and 3-year patient survival rates were 94% and 91.5%, and graft survival rates were 88% and 84%. Although the success rate of operations was not satisfactory at the beginning, the current data reflect a >90% survival rate comparable to the major centers in the world.

Introduction: Chronic liver disease resulting from hepatitis B virus (HBV) and hepatitis C virus (HCV) infections is still a major concern in kidney recipients. It is unclear whether HCV antibody status and markers of HBV infection are associated with renal dysfunction. Thus, we designed a study to investigate the incidence of HBV and HCV infection after renal transplantation and whether these infections alter graft function., Methods: Fifty-eight patients who underwent renal transplantation participated in the study. Serum creatinine and aminotransferase levels were measured with standard automated analyzers. Anti-HCV antibodies were detected with an enzyme immunoassay, and a reverse transcriptase-polymerase chain reaction (RT-PCR) technique was used to test for HCV-RNA. Serological markers for HBV (HBsAg and anti-HBc antibody) were detected by enzyme immunoassay. All samples from patients who were seropositive for HBsAg or anti-HBc antibody were PCR-tested for HBV-DNA. A serum sample collected from living donors was tested for anti-HCV antibodies and serological markers for HBV. Serum creatinine and aminotransferase levels were also measured in living donors., Results: Anti-HCV was not detected in serum samples of any cases before transplantation. However, 10 (17.2%) tested positive after transplantation. HCV-RNA was detected in 2 of the 10 patients (3.4% of all patients). None of the pretransplantation serum samples tested positive for HBsAg. However, anti-HBc antibody was identified in 8 (13.8%) of the 58 patients.. No HBV DNA was detected in serum samples of the patients with anti-HBc or HBsAg-positive. HBsAg was only detected in 1 (1.7%) recipient after transplantation. None of the 58 patients showed clinical signs or symptoms of renal dysfunction during the study period., Conclusion: Our data suggest that, neither HBV nor HCV infection appears to cause or contribute to renal dysfunction in the early period (1 year) after renal transplantation. Nevertheless, a long-term consequence of chronic HBV or HCV liver disease or graft loss is not impossible in renal transplant recipients.

Chronic renal allograft dysfunction is the most common cause of graft loss, for which there are multiple risk factors, including obesity before transplantation, which is believed to lower long-term renal allograft survival. One hundred eighty-two kidney transplant recipients were studied. Body mass index (BMI) at the date of transplantation was calculated. BMI values were classified into 4 categories: (1) patients with BMI <20, (2) BMI between 20 and <25, (3) BMI between 25 and <30, and (4) BMI > or =30. The minimum follow-up period in this study was 3 years after transplantation. The link between categorized BMI and the presence of renal allograft dysfunction and mortality within 3 years posttransplantation was investigated using independent sample t test. BMI at the date of transplantation showed statistically significant association with presence of renal allograft dysfunction and mortality within 3 years posttransplantation (P = .008, P = .01, respectively). BMI at the date of transplantation has a strong association with outcomes after renal transplantation. The extremes of very high and very low BMI are important risk factors for chronic renal allograft dysfunction; therefore, weight adjustment before kidney transplantation can be useful in improving the function of a transplanted kidney and increasing patient's survival.