Duplicated Ureters and Renal Transplantation: A Case-Control Study and Review of the Literature

• Published in: Transplantation proceedings 2013-11, Vol.45 (9), p.3239-3244
• Main Authors: Alberts, V.P, Minnee, R.C, van Donselaar–van der Pant, K.A.M.I, Bemelman, F.J, Zondervan, P.J, Laguna Pes, M.P, Idu, M.M
• Format: Article
• Language: English
• Subjects: Adult; Anastomosis, Surgical; Case-Control Studies; Creatinine - blood; Female; Humans; Kidney Transplantation; Male; Middle Aged; Surgery; Tissue Donors; Ureter - abnormalities
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2013.06.012

Abstract 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. We analyzed our data of double-ureter renal transplantations using a case-control study design. Additionally, we performed a review of the literature. Methods From January 1995 to April 2012, 12 patients received a donor kidney with a double ureter (0.8%). We created a control group of 24 patients matched in age, sex, donor type, and ureteral stenting. Patient charts and surgical reports were reviewed retrospectively. Results In 7 patients both ureters were separately anastomosed to the bladder. In 4 patients a common ostium was created. In 1 patient 1 of the 2 ureters was ligated. No postoperative urologic complications occured. In the single-ureter group, the urologic complication rate was 17% ( P  = .71). Mean creatinine levels after 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 transplantation of a kidney with a duplicated ureter is safe.