{"title":"Stable Outcome After Living Donor Kidney Transplantation Using External Urinary Fistula for a Kidney Graft With Duplicate Ureters: A Case Report","authors":"Hiroyuki Kumata, Kengo Asami, Tomoaki Tabata, Satoshi Sekiguchi","doi":"10.1016/j.transproceed.2025.02.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusions</h3><div>Inserting an external urinary fistula catheter demonstrated many advantages and will be used effectively in the future.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 3","pages":"Pages 430-434"},"PeriodicalIF":0.8000,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation proceedings","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0041134525000879","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
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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.
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.
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