Purpose: We postulated that the pull-through techniques decreased urinary complications rates reported to be 14%. Methods: We operated on 70 cases with donors weighing 6.2+/-1.62 kg. The ureters were reimplanted through a single tunnel (n=34) or a double tunnel (n=36). A ureteral mattress suture was brought into the bladder through a mucosal opening and exited 1 cm distally. The ureter was stented and pulled into the bladder. The anchoring suture was tied. The lateral ureter was stented and brought through the same tunnel or through a separate tunnel. The bladder closure was tested by distending the bladder with antibiotic solution stained with indigo carmine. The stents were removed after 3 weeks. Results: Light hematuria was transient and did not require any therapy. Two kidneys in the single tunnel group clotted off. During nephrectomy the ischemic ureter was pulled out after the anchoring suture was cut. The tunnel was closed with one suture. During cystoscopic stent removal the ureteral reimplantation sites were well healed. Leaks and pyelonephritis were not observed. 3-year graft survival was 95%. Conclusions: The pull-through techniques are easy to perform. The use of the stents avoids the traumatic surgical manipulation, decompresses the ureters, and allows primary healing. The long extramucosal tunnel provides excellent antireflux protection. The techniques are safe and should be added to the armamentarium of the transplant surgeon