BACKGROUND: We reviewed our experience with ureteral complications and secondary ureteral implantation after kidney transplantation.
METHODS: Between 1997 and 2005, 636 patients underwent kidney transplantation at our transplant center. Ureteral implantation was performed in the Lich-Gregoire technique. Thirty-one patients with ureteral complications after kidney transplantation and subsequent secondary ureteral implantation were analyzed for operative parameters and long-term transplant function.
RESULTS: Twenty-seven patients had a ureteral stenosis and 4 patients a ureteral leakage. In 25 patients (81%), a resection of the distal transplant ureter followed by secondary ureteral implantation was performed. In 4 cases (13%), the native ureter was anastomosed to the transplant pelvis and in the remaining 2 cases (6%) to the transplant ureter. Three major complications occurred. At median follow-up of 5 years, 18/30 patients (60%) had a good transplant function and 12/30 patients (40%) had returned to dialysis. One patient with depression died from suicide.
CONCLUSIONS: Secondary ureteral implantation can be performed with acceptable morbidity and good long-term transplant outcome.