The pyelographic appearance of the transplanted cadaver kidney.

Nineteen drip infusion pyelographies were performed on eleven recipients of cadaver kidney transplants of a series of seventeen cadaver grafts performed in this hospital during the past thirty months (up to May 1969). The pyelographic features of the transplanted kidneys were as follows: The transplanted kidneys appeared large, the measurements being 14–17 cm. in length and 7–11 cm. in width, measured on films taken with the patients in prone position. There was good to excellent visualisation of the calyceal pelvic system in all but the first three cases examined. The uretero-pelvic or uretero-ureteric anastomosis was well shown in most of the cases. In five patients, caliectasis and calyceal clubbing of the transplant were noted. It is thought that this might be due to disease inherent to the transplant or to damage of the graft before or after operation. Retrograde flow of the contrast medium from the renal pelvis of the transplant into the original ureter cranial to the anastomosis was a constant feature in all patients. Spontaneous reflux into the ureter opposite the side of the transplant was seen in two cases. No reflux from the bladder was noted into the cadaveric ureter if such was transplanted with the kidney. The existing theories dealing with reflux up the original ureter are discussed. The reflux may be due to lack of ureteric tonus caused by longstanding absence of normal kidney function.