Pediatric renal transplantation in Oman: a single-center experience

Objectives: This study sought to report 22 years experience in pediatric kidney transplantation in Oman

Methods: Electronic charts of all Omani children below 13 years of age who received a kidney transplant from January 1994 to December 2015 were reviewed. Data collected included patient demographics, etiology of end-stage kidney disease, modality and duration of dialysis, donor type, complication of kidney transplantation [including surgical complications, infections, graft rejection] graft and patient survival, and duration of follow-up

Results: During the study period transplantation from 27 living related donors [LRDs], 42 living unrelated donors [LURDs], also referred to as commercial transplant, and one deceased donor were performed. The median age at transplantation was nine years for both groups. The most common primary diagnosis was congenital anomalies of the kidney and urinary tract in 32.8% of patients followed by familial nephrotic syndrome in 20.0% and polycystic kidney disease in 18.5%. Almost half the patients were on hemodialysis before transplantation, 35.7% were on peritoneal dialysis, and 14.2% received preemptive renal transplantation. Children who received LURD kidneys had high surgical complications [42.8%] compared to the LRDs group [17.8%]. Five patients from LURDs group had early graft nephrectomy and four patients developed non-graft function or delayed graft function. In addition, patients in the LURDs group had a higher incidence of hypertension and acute rejection. Graft and patient survival were both better in the LRDs than the LURDs group

Conclusions: Although our pediatric kidney transplant program is a young program it has had successful patient outcomes comparable to international programs. Our study provides evidence that in addition to legal and ethical issues with commercial transplant, it also carries significantly higher morbidity and reduced graft and patient survival

audit of the lithotripsy unit

The aim of the study was to evaluate the performance outcomes of the lithotripsy unit in Royal Hospital in comparison to similar centres, in order to achieve the optimum standard in managing our patients with the least possible adverse effects

Female urethral diverticulum with stones

Female diverticulum is an uncommon problem in the practice of a urologist. Here we report a case of female diverticulum with stones. The most important physical sign was palpation of the sac with the stones on vaginal examination. Micturating cystourethrography was the most useful investigation. Asymptomatic urethral diverticulum may not require surgical correction. However, we suggest that a diverticulum with the stones should be treated with surgical excision to prevent it undergoing malignant change. The aetiology of the candition is not known but in this case histology was suggestive of congenital origin