title: Urinary tract reconstruction using uretero-ureteral end-to-side anastomosis in kidney transplant recipients.
abstract: BACKGROUND
  In kidney transplant recipients, the most widely used method for the reconstruction of the urinary pathway is ureteroneocystostomy, which may be difficult in cases with disused atrophic bladder. In this study, we evaluated kidney transplant recipients who underwent uretero-ureteral end-to-side anastomosis (UUA) in urinary reconstruction due to disused atrophic bladder.
  
  
  METHODS
  To clarify the effectiveness of this method, we retrospectively reviewed the clinical records of kidney transplant recipients in our hospital.
  
  
  RESULTS
  A total of 9 recipients with urinary reconstruction using UUA were evaluated. All of these patients had a history of long-term hemodialysis before transplantation, accompanied by complete anuria and small capacity of the bladder. In 4 patients, cranial native ureter was ligated, whereas it was not ligated in the remaining 5 patients. In 2 of 4 patients with cranial ligation, hydronephrosis developed in the native kidney with no further treatment being required. No patients experienced urinary tract complications including hydronephrosis in the graft, urine extravasation, or urinary tract infection in the follow-up period (757.6 ± 491.3 days). Allograft function was maintained well in all patients (serum creatinine level, 1.08 ± 0.23 mg/dL).
  
  
  CONCLUSIONS
  Although UUA is not a routine method of urinary reconstruction in kidney transplantation, it can be safely performed and should be a surgical option, especially for recipients with disused atrophic bladder. The ligation of cranial native ureter may lead to hydronephrosis of the native kidney, and it is tentatively concluded that UUA without native ureteral ligation is clinically feasible.
authors.affiliation: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan. Electronic address: sr20det@marianna-u.ac.jp.
authors.forename: H
authors.initials: H
authors.lastname: Sasaki
authors.affiliation: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Matsuhashi
authors.affiliation: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nishi
authors.affiliation: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Hachisuka
authors.affiliation: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Katsuoka
authors.affiliation: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kudo
authors.affiliation: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kitajima
authors.affiliation: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yoshioka
authors.affiliation: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Nakazawa
authors.affiliation: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Miyano
authors.affiliation: Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Yazawa
authors.affiliation: Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Imai
authors.affiliation: Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kawarazaki
authors.affiliation: Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Shibagaki
authors.affiliation: Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Department of Urology, St. Marianna University School of Medicine, Miyamae-ku, Kawasaki, Kanagawa, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Chikaraishi
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D001284:Atrophy / Q000209:etiology / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D016030:Kidney Transplantation; D008026:Ligation; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D006435:Renal Dialysis / Q000009:adverse effects; D012189:Retrospective Studies; D014513:Ureter / Q000601:surgery*; D001743:Urinary Bladder / Q000473:pathology* / Q000601:surgery*