Korean J Transplant.  2023 Nov;37(Suppl 1):S19. 10.4285/ATW2023.F-5842.

Experience of using the recipient's appendix for the formation of an artificial ureter during kidney transplantation

• Kuttymuratov G
• Ainakulov A

• KMID: 2551593
• DOI: http://doi.org/10.4285/ATW2023.F-5842

Abstract

Background
In cases of obtaining a very short ureter during kidney explantation from a donor, there are cases when, due to its very short length, it is impossible to anastomose with the recipient’s bladder. Also, in the absence of a native ureter and with a small volume of the recipient’s bladder, we use the recipient’s appendix to form and lengthen the ureter.
Methods
In our clinic, there was one case of using the appendix to lengthen the ureter during kidney transplantation. During the removal of a kidney from a donor, the ureter was accidentally cut short. A 14-year-old recipient with terminal kidney disease 3 years ago underwent nephroureterectomy on both sides, which prevented the use of his native ureter. Also, the child has a small bladder volume, which did not allow using the bladder wall to lengthen the ureter. A laparotomy was performed, the appendix was isolated with the mesentery and moved to form an artificial ureter and anastomosis with the graft ureter and the recipient’s bladder.
Results
In the postoperative period, the healing of the appendix was satisfactory. The ureteral stent was removed 28 days after transplantation. A month later, during computed tomography and ultrasound examinations, the condition of the anastomoses was satisfactory. The graft function, urination is satisfactory. The patient was discharged on the 35th day after the operation.
Conclusions
in the above cases, the use of the appendix for the formation and lengthening of the ureter of the renal graft is considered the method of choice.