PMID- 38161090
OWN - NLM
STAT- MEDLINE
DCOM- 20240408
LR  - 20240408
IS  - 1531-5037 (Electronic)
IS  - 0022-3468 (Linking)
VI  - 59
IP  - 4
DP  - 2024 Apr
TI  - The Effectiveness of Deflux(R) Treatment for Vesicoureteral Reflux Following 
      Pediatric Renal Transplantation: A Single-Institution Challenging Experience.
PG  - 616-620
LID - S0022-3468(23)00736-4 [pii]
LID - 10.1016/j.jpedsurg.2023.12.005 [doi]
AB  - PURPOSE: To validate the effectiveness of Deflux(R) treatment for vesicoureteral 
      reflux (VUR) following pediatric renal transplantation (RT), based on our 
      single-institution experience. METHOD: A retrospective study was conducted using 
      the medical records of pediatric patients who underwent Deflux(R) treatment for VUR 
      after RT from April 2008 to March 2022. RESULTS: Sixty-eight pediatric patients 
      underwent RT. VUR was subsequently detected in 22 (32 %) of these patients. Seven 
      of the 22 patients (32 %) underwent Deflux(R) treatment to avoid renal dysfunction 
      due to urinary infection (UTI). The median age at the time of RT was 4 years 
      (range:2-12). All 7 patients had urinary UTIs before Deflux(R) treatment. The 
      median estimated glomerular filtration rate (eGFR) before Deflux(R) treatment was 
      67 ml/min/1.73 m(2) (range:42-138 ml/min/1.73 m(2)). After Deflux(R) treatment, VUR 
      was downgraded in three cases (43 %). Four patients (57 %) experienced 
      postoperative UTI, two of who underwent a second Deflux(R) treatment, one underwent 
      submuscular tunnel reconstruction, and the other one experienced UTI without VUR 
      after 1st Deflux(R) treatment but did not reoccur. All seven patients continued 
      prophylactic medication after Deflux(R) treatment, without any history of recurrent 
      UTIs during the observation period after treatment (median 37 months [range 7-86 
      months]). Furthermore, the eGFRs did not significantly decrease after Deflux(R) 
      treatment (median eGFR 58 ml/min/1.73 m(2) [range:33-99 ml/min/1.73 m(2)], 
      p > 0.1). CONCLUSION: Deflux(R) treatment for VUR after RT is technically 
      challenging because the new ureteral orifice is ventrally anastomosed at the 
      bladder. We believe our results indicate the possibility of reducing the 
      frequency of UTIs and contributing to preservation of the renal function after 
      RT. TYPE OF STUDY: Retrospective Study. LEVEL OF EVIDENCE: Level III.
CI  - Copyright (c) 2023 Elsevier Inc. All rights reserved.
FAU - Obata, Satoshi
AU  - Obata S
AD  - Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu 
      University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan; 
      Department of General Thoracic, Breast and Pediatric Surgery, Fukuoka University 
      School of Medicine and Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, Fukuoka 
      814-0180, Japan. Electronic address: s.obata.eh@adm.fukuoka-u.ac.jp.
FAU - Nagata, Kouji
AU  - Nagata K
AD  - Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu 
      University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
FAU - Suematsu, Shinya
AU  - Suematsu S
AD  - Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 
      3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
FAU - Nishiyama, Kei
AU  - Nishiyama K
AD  - Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 
      3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
FAU - Okabe, Yasuhiro
AU  - Okabe Y
AD  - Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu 
      University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
FAU - Kondo, Takuya
AU  - Kondo T
AD  - Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu 
      University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
FAU - Maniwa, Junnosuke
AU  - Maniwa J
AD  - Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu 
      University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
FAU - Fukuta, Atsuhisa
AU  - Fukuta A
AD  - Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu 
      University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
FAU - Kawakubo, Naonori
AU  - Kawakubo N
AD  - Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu 
      University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
FAU - Yanagi, Yusuke
AU  - Yanagi Y
AD  - Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu 
      University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
FAU - Miyata, Junko
AU  - Miyata J
AD  - Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu 
      University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
FAU - Matsuura, Toshiharu
AU  - Matsuura T
AD  - Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu 
      University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
FAU - Ohga, Shouichi
AU  - Ohga S
AD  - Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 
      3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
FAU - Nakamura, Masafumi
AU  - Nakamura M
AD  - Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu 
      University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
FAU - Tajiri, Tatsuro
AU  - Tajiri T
AD  - Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu 
      University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.
LA  - eng
PT  - Journal Article
DEP - 20231212
PL  - United States
TA  - J Pediatr Surg
JT  - Journal of pediatric surgery
JID - 0052631
RN  - 0 (deflux)
RN  - 0 (Dextrans)
RN  - 9004-61-9 (Hyaluronic Acid)
SB  - IM
MH  - Child
MH  - Humans
MH  - Infant
MH  - Child, Preschool
MH  - *Vesico-Ureteral Reflux/etiology/surgery
MH  - *Kidney Transplantation/adverse effects
MH  - Retrospective Studies
MH  - Dextrans/therapeutic use
MH  - Hyaluronic Acid/therapeutic use
MH  - *Urinary Tract Infections/etiology/prevention & control/drug therapy
OTO - NOTNLM
OT  - Deflux(R)
OT  - Renal function
OT  - Renal transplantation urinary tract infection
OT  - Vesicoureteral reflux
EDAT- 2024/01/02 11:42
MHDA- 2024/04/08 06:42
CRDT- 2023/12/31 21:52
PHST- 2023/11/30 00:00 [received]
PHST- 2023/12/04 00:00 [accepted]
PHST- 2024/04/08 06:42 [medline]
PHST- 2024/01/02 11:42 [pubmed]
PHST- 2023/12/31 21:52 [entrez]
AID - S0022-3468(23)00736-4 [pii]
AID - 10.1016/j.jpedsurg.2023.12.005 [doi]
PST - ppublish
SO  - J Pediatr Surg. 2024 Apr;59(4):616-620. doi: 10.1016/j.jpedsurg.2023.12.005. Epub 
      2023 Dec 12.