Duplicated Ureters and Renal Transplantation: A Case-Control Study and Review of the Literature

Alberts, Victor P.; Minnee, Robert C.; Pant, Karlijn A.M.I. van Donselaar-van der; Bemelman, Fréderike J.; Zondervan, Patricia J.; Pes, M. Pilar Laguna; Idu, Mirza M.

doi:10.1016/j.transproceed.2013.06.012

Cited by 16 publications

(35 citation statements)

References 19 publications

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“…Although complete ureteral duplication in the donor has previously been a contraindication for renal transplantation, recent renal transplantation cases with completely duplicated ureters have been reported as successful with respect to post-operative graft function [5,9,10].…”

Section: Discussionmentioning

confidence: 99%

“…Completely duplicated ureters require several modifications to the extravesical ureteroneocystostomy. There are two primary approaches to re-implantation of duplicated ureters with the extravesical ureteroneocystostomy technique; both ureters can be separately anastomosed to the bladder [5], or a common ureteral ostium connected to the bladder can be formed between the distal parts of each ureter, known as ureteroureteral terminolateral anastomosis [6,7,9].…”

Section: Discussionmentioning

confidence: 99%

“…Although ureteral duplication is the most common congenital malformation of the urinary tract, few cases in the literature describe kidney transplantations with completely duplicated ureters [1][2][3]5,7,9,10]. Here, we report a case study on cadaveric kidney transplantation from a completely duplicated ureter by modified extravesical ureteroneocystostomy where distal ureteric ends of duplicated ureters were spatulated and then their medial edges were approximated.…”

Section: Discussionmentioning

confidence: 99%

“…The condition is not problematic as long as both ureters enter orthotopically or if the duplication is incomplete [1,2]. A kidney with duplicated ureters is more susceptible to post-operative urinary tract infections, stricture, reflux and urinary leakage; therefore, it is not a preferred option in kidney transplantations, in which postsurgical complications are the predominant cause of morbidity [3][4][5]. However, recent studies have revealed that the development of complications after transplantation of a donor kidney does not differ between completely duplicated ureters and a single ureter [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…A kidney with duplicated ureters is more susceptible to post-operative urinary tract infections, stricture, reflux and urinary leakage; therefore, it is not a preferred option in kidney transplantations, in which postsurgical complications are the predominant cause of morbidity [3][4][5]. However, recent studies have revealed that the development of complications after transplantation of a donor kidney does not differ between completely duplicated ureters and a single ureter [5][6][7]. Given the increase in the number of hemodialysis patients over recent decades, and the shortage of renal allografts, development of a range of surgical techniques without postoperative complications is critical for the successful transplantation of a donor kidney with completely duplicated ureters [2,7,8].…”

Section: Introductionmentioning

confidence: 99%

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Modified Extravesical Ureteroneocystostomy in Cadaveric Kidney Transplantation with Completely Duplicated Ureters: A Case Report

Bozkurt¹

2014

J Transplant Technol Res

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Completely duplicated ureters are not commonly used in renal transplantation due to increased risk of postoperative complications, such as urinary tract infections, stricture, reflux and urinary leakage. Although recent results have indicated that the occurrence of these complications is similar to that of a single ureter, few reports exist of renal transplantations of kidneys with ureteral duplication. Here, we report successful renal transplantation of a cadaveric kidney with completely duplicated ureters to a 52-year-old final stage renal disease patient who had been on dialysis for 19 years. A modified extravesical ureteroneocystostomy technique was employed, in which distal ureteric ends were spatulated and their medial edges were approximated. Double-j stent catheters were inserted during the ureteroneocystostomy and removed after 21 days when progressive serum creatine levels had decreased. During 6 months following the operation so far, no urinary tract infections, hydronephrosis, pyelonephritis, stricture, or reflux was reported. We conclude that modified extravesical ureteroneocystostomy, a newly described technique is suitable for the transplantation of a cadaveric kidney with complete ureteral duplication.

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Section: Discussionmentioning

confidence: 99%