Kidney transplant grafts with complete ureteral duplication.

Objectives: To evaluate the outcome of renal transplants using donor grafts with complete ureteral duplication.
Materials and Methods: Between 1999 and 2011, we performed 1368 kidney transplant procedures, including 87 dual kidney transplants. There were 12 transplants with donor kidneys that had complete ureteral duplication, including 2 patients who had grafts with ureteral duplication that were used to perform a dual kidney transplant. In 11 patients with ureteral duplication, the 2 ureters were anastomosed separately to the bladder with a double Lich-Gregoir technique; in 1 patient, a ureteroureteral terminolateral anastomosis and single ureteroneocystostomy were performed.
Results: Urinary tract infections were noted during the first year after transplant in 7 patients (58%) that had kidney grafts with duplicated ureters (4 patients with 1 infection each; 3 patients with 2 infections each), but none developed pyelonephritis, functional impairment, or graft loss. There were no other urologic or renal complications observed in recipients of grafts with ureteral duplication.
Conclusions: Donor kidneys with ureteral duplication may be used in renal transplant. The double Lich-Gregoir technique may provide excellent results.