Transplantation of kidneys with duplicated ureters

Heidari, Mohammad; Gharaati, Mohammad Reza; Iran-Pour, Elham; Simforoosh, Nasser; Zare, Samad; Basiri, Abbas

doi:10.3109/00365599.2010.485577

Cited by 7 publications

(8 citation statements)

References 14 publications

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“…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%

“…The duplicated ureters anostomosed in distal part to form a single cuff were then sutured on the mucosa of the bladder. This technique is different from the modified extravesical ureteroneocystostomy described in literature where both distal ends of the ureters were anastomosed to each other and then the modified Lich technique was used for ureteroneocystostomy [6]. Because the use of double-j stent catheters in extravesical ureteroneocystostomy, especially with narrow ureters, has been shown to be associated with a reduction in post-operative urological complications in renal transplantation [13], we inserted double-j stent catheters in both lumens of the single-cuffed ureters during the extravesical ureteroneocystostomy.…”

Section: Discussionmentioning

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%

See 2 more Smart Citations

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: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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. 4,9,10 In the present patients, the Lich-Gregoir technique gave excellent results, comparable to the results of transplant with 1 ureter.…”

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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“…Implantation: Both ureters may be implanted through separate incisions in the bladder, or they may be spatulated and joined along one edge before being implanted as a single ureter (36)(37)(38).…”

Section: Retrievalmentioning

confidence: 99%