Reconstruction of ureteral necrosis in kidney transplantation using an ileum interposition

Transplantation Proceedings
Heiner H WoltersOlaf Brinkmann

Abstract

Ureteral necrosis is a serious problem in kidney transplantation. Sometimes re-ureterocystostomy is possible, while other cases require an elaborate reconstruction to maintain kidney function. We report our experience with ileum interposition for ureteral reconstruction. After 9 years of dialysis treatment a 58-year-old patient was grafted using the left kidney of a 59-year-old donor with a cold ischemic time of 9.5 hours. The early postoperative course was uneventful apart from delayed graft function. Immunosuppression consisted of an IL-2-receptor antibody, calcineurin inhibitor, mycophenolate mofetil, and corticosteroids. Discharge serum creatinine was 2.3 mg/dL. In month 4 the patient showed a pararenal urinoma; cystoscopy revealed necrosis of the distal ureter. Operative revision showed urine leakage from the renal pelvis through the urinoma into the bladder. As the whole ureter was necrotic, a re-ureterocystostomy was not possible. The patient's own ureter had been extirpated, and the bladder was too small to do a direct anastomosis between it and the kidney. Consequently, an ileum interposition was performed. The postoperative course was uneventful. Kidney function was stable with a nadir creatinine concentration of 2.0 ...Continue Reading

References

Jan 1, 1992·Urologia Internationalis·M DecurtinsF Largiadèr
Mar 1, 1974·Urology· Campos Freire JúniorJ G de Campos Freire
Jul 1, 1994·Transplant International : Official Journal of the European Society for Organ Transplantation·H KellerG Kirste
Jan 1, 1998·Transplantation Proceedings·B Cohen, G G Persijn

❮ Previous
Next ❯

Citations

Feb 22, 2011·Transplantation Proceedings·M Giessing
Mar 8, 2017·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Erich K Lang
Mar 20, 2020·International Journal of Urology : Official Journal of the Japanese Urological Association·Shengwei XiongXuesong Li
May 5, 2021·Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie·S RouxA Méjean

❮ Previous
Next ❯

Related Concepts

Related Feeds

Bladder Carcinoma In Situ

Bladder Carcinoma In Situ is a superficial bladder cancer that occurs on the surface layer of the bladder. Discover the latest research on this precancerous condition in this feed.