INTRODUCTION: Lower urinary tract abnormalities are found in up to15% of adults and in 20-30% of children requiring kidney transplantation. Several will necessitate an enterocystoplasty prior to transplantation to avoid possible graft damage secondary to a hostile bladder. There is no consensus regarding where the best technique to be used. Here we provide a detailed revision on 30 consecutive cases.MATERIAL AND METHODS: From our kidney transplant database we identified all cases of ureteroenterostomy. The following variables were collected: Surgical technique for the reimplanataion, underlying urological condition, complications, and graft function.RESULTS: From 2010 to 2015, 30 cases of ureteroenterostomy were identified with a follow up of 16 to 67 months: 8 recipients from living related and 22 from deceased donors. The underlying urological was:10 posterior urethral valves, 13 neurogenic bladder, 4 bladder exstrophy, 2 genitourinary tuberculosis and 1 rabdomiossarcoma. Mean time of the enterocystoplasty before the transplantation was 20,6 (3-200) months and all patients underwent pre transplant evaluation with cystography and urodynamic evaluation. In 16 cases the graft ureter was sutured directly to ileum mucosa with running absorbable sutures (similar to Gregoir), in 9 cases interrupted stitches including all layers of the bowel wall and in 5 cases a sub mucosal tunnel was preformed (modified le Duc). A ureteric stent was placed was placed in 6 according to the surgeon discretion and a Foley catheter left for 3 to 4 weeks. Two urinary fistulas were identified (6,6%), one in the 40 postoperative day. On surgical exploration a necrosis of the distal ureter was found and the patient treated with an ureteropylostomy. In the second case the fistula was diagnosed on the 7 postoperative day after clogging of the Foley catheter with mucus. On surgical exploration a partial dehiscence of the anastomosis was found and the ureter reanastomosed to ilium in a similar fashion. No anastomotic strictures were identified.CONCLUSION: Despite the surgical technique employed ureteroenterostomy is a safe procedure with low complication rate (6%) and no strictures in our experience.

CITATION INFORMATION: Marinho Neto H, Leslie B, Neves Neto J, Almeida M, Pessoa A, Offernni J, Nogueira M, Ximenes S, Aguiar W, Tedesco H, Medina Pestana J. Ureteroenterostomy in Kidney Transplant: Retrospective Analysis of 30 Consecutive Cases. Am J Transplant. 2016;16 (suppl 3).

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