Ureteric jet in renal transplantation patient

We have made a case for an active sphincteric mechanism at the VUJ modifying the ureteric jet Doppler waveform. The transplanted ureter does not have a normal VUJ, but retains inherent peristalsis. This study was to document any difference in the transplanted ureteric jet Doppler pattern. A total of 55 transplant patients and 817 healthy subjects were recruited. The Doppler waveform of the transplanted ureter is distinctly different from that of the healthy adult ureter. There are two major patterns: a short monophasic waveform is the most common (66.1% vs. 2.6% in healthy ureters). Less common is a longer, more phasic, pattern, which, however, does not resemble the patterns of the healthy ureter. This supports the hypothesis that the mode of action at the VUJ is sphincteric, because this is lost with transplantation, and ureteric drainage reverts to a simple unmodified pattern.