A Novel Surgical Option for Urinary Tract Reconstruction in Third Renal Transplantation

Renal transplantation is generally accepted to be the best treatment for patients with end‐stage renal disease, which is associated with better quality of life and better life expectancy compared with dialysis. Although the allograft survival following renal transplantation continues to improve, the absolute number of patients suffering from allograft loss continues to grow due to the increasing number of surviving renal transplant recipients. Thus, an increasing number of patients are willing to undergo renal re‐transplantation. Due to the shortage of organ donors, the use of marginal donors including donors with ureteropelvic junction obstruction (UPJO) is becoming more prevalent.[1] An anastomosis of allograft pelvis to native ureter has been reported to be a treatment for donor kidney with UPJO at initial transplantation;[2] however, few studies focused on the surgical option for urinary tract reconstruction of donor kidney with UPJO in re‐transplantation. The aim of this report was to provide and evaluate a novel surgical option for urinary tract reconstruction in third renal transplantation, using preexisting allograft ureteropyelostomy (UP), which we believe represents an innovative surgical technique for renal transplantation in the world.