Complete necrosis of the graft ureter is a rare but serious complication following kidney transplant. In a patient with antiphospholipid syndrome, a combination of factors such as arterial thromboembolism, hematoma formation, and surgical collateral damage can cause ischemia of the graft ureter. Preoperative optimization of disease activity and coagulation with meticulous preservation of ureteric perfusion may help in prevention.
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