Results of secondary ureteral implantation after kidney transplantation

We reviewed our experience with ureteral complications and secondary ureteral implantation after kidney transplantation.

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.

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.

Secondary ureteral implantation can be performed with acceptable morbidity and good long-term transplant outcome.