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Nephrology Dialysis Transplantation, Vol 14, Issue 6 1521-1524, Copyright © 1999 by Oxford University Press

ORIGINAL ARTICLES

Ureteral complications in renal transplantation with more than one donor ureter

A Haferkamp, J Dorsam, K Mohring, M Wiesel and G Staehler
Department of Urology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany; Corresponding author

Background: The purpose of this study was to evaluate the ureteral complications of renal transplant recipients with more than one donor ureter. Methods: Between 1967 and 1997, 19 patients (median age 37 years, range 6-62 years) received renal transplants from donors with more than one ureter. There were 18 donor organs with two ureters, and one patient underwent en bloc renal transplantation with four donor ureters. In nine patients, the ureters were implanted separately at the bladder dome according to the extravesical technique of Witzel, Sampson, Lich and Rohl, In 10 patients, we performed a modification of this extravesical technique according to Nghiem with a side-to-side anastomosis of the ureters before completing the ureteroneocystostomy. Results: After a median follow-up of 55 months (range 2-218 months), no graft loss due to ureteral complications as noted. One patient died due to myocardial infarction, seven patients returned to dialysis without ureteral complications. There were two patients (one patient after side-to-side ureteral anastomosis, one patient with separate implantation of the two ureters) with ureteral obstruction of one donor ureter. Both patients underwent open surgical revision with temporarily placement of internal ureteral stents. Conclusions: The presence of multiple ureters for donor kidneys is associated with a higher complication rate in our patient population compared with donor kidneys with one ureter. There was no difference in the long-term outcome between the two implantation techniques used. Key words: renal transplantation; ureter; ureteroneocystostomy
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