Experiences in Kidney Transplantation With Duplicated Ureters

Sulikowski, Tadeusz; Ziętek, Z; Ostrowski, Marek; Kamiński, Marek; Sieńko, Jerzy; Romanowski, M; Majewski, Włodzimierz; Ostrowska-Clarck, K.; Domański, Leszek; Różański, Jacek; Ciechanowski, Kazimierz

doi:10.1016/j.transproceed.2005.03.041

Cited by 15 publications

(14 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%

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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%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…5,7 There have been few reports about kidney transplants with donor kidneys that have complete ureteral duplication. The technique of ureteroneocystostomy is not well established, and other techniques have shown excellent outcomes, such as spatulating the distal tract of the 2 ureters from the medial surface (suturing side to side), performing single ureteroneocystostomy, 8 or performing 2 different anastomoses with 1 or 2 myotomy incisions.…”

Section: Discussionmentioning

confidence: 99%

Kidney Transplant Grafts With Complete Ureteral Duplication

Lasaponara¹,

Dalmasso²,

Bosio³

et al. 2013

Exp Clin Transplant

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Objectives: To evaluate the outcome of renal transplants using donor grafts with complete ureteral duplication. Materials and Methods: Between 1999 and 2011, we performed 1368 kidney transplant procedures, including 87 dual kidney transplants. There were 12 transplants with donor kidneys that had complete ureteral duplication, including 2 patients who had grafts with ureteral duplication that were used to perform a dual kidney transplant. In 11 patients with ureteral duplication, the 2 ureters were anastomosed separately to the bladder with a double Lich-Gregoir technique; in 1 patient, a ureteroureteral terminolateral anastomosis and single ureteroneocystostomy were performed. Results: Urinary tract infections were noted during the first year after transplant in 7 patients (58%) that had kidney grafts with duplicated ureters (4 patients with 1 infection each; 3 patients with 2 infections each), but none developed pyelonephritis, functional impairment, or graft loss. There were no other urologic or renal complications observed in recipients of grafts with ureteral duplication. Conclusions: Donor kidneys with ureteral duplication may be used in renal transplant. The double LichGregoir technique may provide excellent results.

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“…5,6 After transplant, double ureters may be associated with a higher risk of infection, hydronephrosis, ureteral necrosis, and leakage. 7,8 The present multicenter study describes our experience and outcome of kidney transplants with double ureters. To our knowledge, this is the largest reported series.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2015

Exp Clin Transplant

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Objectives: Renal transplant with double ureters is uncommon. However, with increasing numbers of en bloc and dual transplants from marginal donors, we frequently observe 2 ureters for implant. The current study reviewed our experience with 76 double-ureter renal transplants. Materials and Methods:We performed a retrospective analysis of renal transplant performed in 2 institutes from 1996 to 2011. We recorded the outcomes of renal transplants with double ureters including complications. We compared outcomes with renal transplants with single ureters. Results: Irrespective of the technique used for implant, we recorded no significant risk of complications of double-compared with singleureter renal transplants. There were no significant differences in patient and graft survival. Conclusions: We believe that double-ureter transplant does not require additional risk discussion with the recipient because it is safe. However, when ureteral stents are used, we should ensure that a mechanism is in place for both stents to be removed postoperatively.

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Experiences in Kidney Transplantation With Duplicated Ureters

Cited by 15 publications

References 19 publications

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

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

Kidney Transplant Grafts With Complete Ureteral Duplication

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