NIV Congres

Introduction Complications of the transplant ureter are the most important cause of surgical morbidity after renal transplantation. The presence of ureteral duplication in the renal graft might result in an increased complication rate when compared with single ureter renal grafts. We analyzed our data of double ureter renal transplantations and performed a review of the existing literature.

Methods From January 1995 to April 2012, 1588 kidney transplantations were performed at the Academic Medical Center Amsterdam. Patient charts and surgical reports were reviewed retrospectively.

Results Twelve patients received a donor kidney with a double ureter (0.8%). In seven patients both ureters were separately anastomosed to the bladder, using two submucosal tunnels. In four patients a common ostium was created at the distal end of the double ureter and subsequently one anastomosis was performed to the bladder. In one patient one of the two ureters was ligated. No postoperative urological complications occured among the patients receiving a kidney with a double ureter. In the group who received a kidney with a single ureter, the urological complication rate was 14% (P=0.17). Mean creatinine levels at one week, one month and three months after kidney transplantation were comparable between both groups.

Discussion A double-ureter donor kidney is not associated with an increased complication rate after renal transplantation and yields equal outcomes as compared to single-ureter donor kidneys. We conclude that a duplicated ureter does not have to be a contraindication for renal transplantation.