Objective: To deepen the understanding of patients with complete necrosis of the ureter after renal transplantation for early diagnosis and treatment.

Methods: Of 5 patients with complete necrosis of the ureter after renal transplantatioin between January 1991 and April 2001 in our hospital, 4 were male and 1 was female (mean age, 35 years). Seven to 12 days after renal transplantation, native pyeloureterestomy was performed for 1 patient, and the remaining 4 patients received the cutting of the diatal necrosis ureter and vesicoureterostomy because of urine leakage. Six to seven weeks later when the ureter stents were pull out, native pyeloureterestomy or pyeloureteroplasty was performed for the 4 patients because of uropenia and hydronephrosis.

Results: Five patients showed normal function of the kidney postopcreation (follow up: 6 - 12 months) without hydronephrosis.

Conclusions: When distal necrosis of the ureter is observed after renal transplantation, complete necrosis of the ureter may occur. Native pyeloureterostomy or pyeloureteroplasty is an effective treatment.

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