Korean J Transplant.  2022 Nov;36(Supple 1):S101. 10.4285/ATW2022.F-2219.

Usefulness of ureteroureterostomy for kidney transplantation

• Lee SH
• Jeong JH
• Kong JM

• KMID: 2535617
• DOI: http://doi.org/10.4285/ATW2022.F-2219

Abstract

External ureteroneocystostomy (UNC) is a standard method for kidney transplantation. Some of the recipients, particularly with long dialysis vintage, may have small and contracted bladder having a hard and friable wall, where UNC is difficult to be performed, and complications such as stenosis or urine leak frequently occur. Ureteroureterostomy (UUS) has an advantage of maintaining the natural anti-reflux anatomy of vesicoureteral junction, but the prevention of stenosis at the site of anastomosis is challenging. We have four cases of successful UUS; three patients with contracted bladder and one case with very short donor ureter. The first case had hemodialysis vintage of 15 years. the bladder volume on the preoperative cystography was 50 cc, which increased to 450 cc after 3.5 years. The second case had hemodialysis vintage of 14 years, had a preoperative bladder volume 80 cc, which increased to 400 cc after 4 years. The vintage of peritoneal dialysis of the third case was 9 years. Preoperative bladder volume was 50 cc, that increased to 350 cc at 9 months. The ureter of cadaveric donor kidney of the 4th case was accidentally cut at the pelvis level during harvest. A double J catheter was inserted during the surgery, which was removed after one month. No cases of urine leak or stenosis was observed. UUS would be a useful alternative for patients with a contracted bladder or a short donor ureter.