Ureteric Stricture following Pediatric Dual En-Bloc Renal Transplantation

This is a case report examining a urine leak and ureteric stricture following pediatric dual en-bloc renal transplantation. Despite intraoperative ureteric stenting, and post-operative nephrostomy, urinary leak continued. Both grafts grew in size from 5 cm at implantation, to 9.5 cm within 3 months. Ureteric reconstruction would expose the patient to unacceptable risk of losing both grafts, due to the close proximity of the ureters. A transplant nephrectomy of the obstructed graft was therefore undertaken. Transplant nephrectomy of a single obstructed graft is a viable option following an enbloc transplantation, where the remaining kidney can continue to provide sufficient renal replacement therapy.