%0 Journal Article
%T Management of Bilateral Ureteral Obstruction After Transplantation of Pediatric En Bloc Kidneys, a Case Report and Review of Available Literature
%A Balamurugan Sankarapandian
%A Eryberto Martinez
%A George Rofaiel
%A Gilbert Pan
%A Ikponmwosa Iyamu
%A Sameh Fayek
%A Sridhar R. Allam
%J Archive of "Transplantation Direct".
%D 2019
%R 10.1097/TXD.0000000000000916
%X There is a large discrepancy between the number of organ donors and number of patients on the kidney transplant list. Based on Organ Procurement and Transplantation Network data as of January 14, 2019, over 94 886 patients are on the waiting list for a kidney transplant in the United States. The growth in kidney transplantation has been sluggish, with roughly only 21 167 cases performed in 2018. The number of living-donor procedures performed has also remained stagnant for several years. Patients who are unable to receive transplants face high mortality and morbidity related to end-stage renal disease needing dialysis. Such discrepancy between organ supply and demand prompts the necessity for novel sources of donors using an expanded criteria for donor organs. Pediatric donors provide a resource to increase the number of kidneys available for transplant. As a group, they have also proven to provide equivalent or superior long-term outcomes compared with standard adult kidneys despite an increase in associated surgical risks due to the potential for ureteral complications, graft thrombosis, and concerns regarding low nephron mass.1-4 Overall, kidneys donated from pediatric donors have demonstrated favorable outcomes.5 Ureteral complications happen because of multiple reasons including congenital abnormalities. In this article, we describe one example of such complication that was diagnosed after the transplant was performed. There has not been an established precedent on how to manage a ureteral pelvic junction obstruction (UPJO)/ureteral stricture in pediatric kidneys posttransplantation. Standard maneuvers were attempted at first. When these measures failed, we had to modify our approach, and after several disappointments our patient finally had success
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616144/