Stable Outcome After Living Donor Kidney Transplantation Using External Urinary Fistula for a Kidney Graft With Duplicate Ureters: A Case Report

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-02-27 DOI:10.1016/j.transproceed.2025.02.017

Hiroyuki Kumata, Kengo Asami, Tomoaki Tabata, Satoshi Sekiguchi

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引用次数: 0

Abstract

Background

A kidney with a duplicate ureter used as a graft in kidney transplantation poses a concern about the risk of suture failure at the ureterovesical anastomosis. Many institutions attempted to reduce complications by placing internal fistula stents, such as Double J Stents, at the anastomotic site. We actively place external fistula catheters in these high-risk cases at our hospital.

Case presentation

A 65-year-old male patient developed chronic renal failure due to diabetic nephropathy and underwent a preemptive living kidney transplant with his wife as the donor, but the graft contained two duplicate ureters. We established a method to prevent serious complications by inserting an external urinary fistula catheter during ureterovesical anastomosis. The anastomosis and ureter were directly assessed by injecting a contrast medium postoperatively for external urinary fistulas. Distinguishing and measuring the amount of urine from each ureter becomes possible. Additionally, it was useful for urinary training postoperatively. Noteworthily, the catheter can be removed simply by pulling it out and does not require a cystoscope. The patient achieved an uneventful postoperative course and was discharged from the hospital.

Conclusions

Inserting an external urinary fistula catheter demonstrated many advantages and will be used effectively in the future.

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使用尿道外瘘为双输尿管肾移植进行活体肾移植后的稳定结果：病例报告。

背景：在肾移植中，有重复输尿管的肾脏被用作移植物，引起了输尿管膀胱吻合术缝合失败的风险。许多机构试图通过在吻合口放置内瘘支架，如双J型支架来减少并发症。我们积极在这些高危病例放置外瘘导管。病例介绍：一名65岁男性患者因糖尿病肾病而出现慢性肾衰竭，他的妻子作为供体接受了先发制人的活体肾脏移植手术，但移植物含有两个重复的输尿管。我们建立了输尿管膀胱吻合术中置入外尿瘘导管以防止严重并发症的方法。尿道外瘘术后直接注射造影剂评价吻合口及输尿管。区分和测量每个输尿管的尿量成为可能。此外，它还有助于术后尿路训练。值得注意的是，只需将导管拔出即可取出，无需膀胱镜检查。患者术后顺利出院。结论：置入外尿瘘导尿管具有诸多优点，在今后的临床应用中具有一定的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.