What do you do in the case of a short ureter or absence of a native ureter in kidney transplantation?
Manuel Melo y Escalante, MD
Response from Ron Shapiro, MD
This is really 2 or 3 different questions. In the case of a short donor ureter, it is relatively straightforward to anastomose the transplant ureter to the native ureter, either end-to-side or end-to-end; we routinely stent these anastomoses for 6 weeks. Occasionally, it may be necessary to remove the native kidney if one is performing an end-to-end reconstruction; but, in fact, it is generally agreed that this is usually not necessary, and in my experience, this has been the case.
If the transplant ureter is normal and the native ureter is not present, a standard ureteroneocystostomy would be sufficient. In the unusual circumstance where the transplant ureter is short and the native ureter is not present (I am not actually sure that I have ever seen this, to be honest), one could use the contralateral native ureter, or one could construct a Boari flap using the bladder.
Medscape Transplantation. 2003;4(2) © 2003 Medscape
Cite this: Ron Shapiro. Short or Absent Native Ureter? - Medscape - Dec 02, 2003.