Wang MK, et al. - Experts presumed that on follow-up, those with pre-transplant lower urinary tract (LUT) dysfunction would have lower glomerular filtration rate (GFR). They found that over time, pediatric post-transplant GFR after open redo ureteral reimplant decreased in similar fashion in subjects having symptomatic reflux notwithstanding of whether they had LUT dysfunction or normal anatomy. Regardless of LUT status, vigilance ought to be applied to the recognition, treatment, and follow-up of all symptomatic transplant reflux.