A survey in Japan reported that the patients undergoing dialysis (HD) are increasing every year, and the number has reached 329,609 at the end of 2016. Out of them, 26,313 patients were undergoing longterm HD (LHD; 20 or more years), which is 8.3% of the total number. The number of deceased donor RTx (DRTx) did not increase, while the number of patients enrolled in the waiting list for DRTx reached approximately 13,000. Considering the Mean Waiting Period, LHD patients morbidity and mortality a study was designed by Koichi Kozaki, et al. to investigate the results of RTx in LHD patients. Ninety patients underwent RTx between May 2006 and December 2017, of which 14 patients were in the LHD group. The most important surgical problem in RTx of the patients on LHD is a contracted disuse bladder (CDB). Its incidence was 42.9% (6 out of 14 patients) in LHD group and 5.3% (4 out of 76 patients) in non-LHD group respectively, significantly higher in non-LHD group than in non-LHD group(p=0.02). All of patients with a CDB underwent ureteroureterostomy. Patients on LHD showed significantly lower graft survival and patient survival rate than those on non-LHD. Take a step to share your views on the Preoperative evaluation and perioperative countermeasures which needs to be required in LHD patients through online at https://www.scitechnol.com/submission/ or through email at transplantation@scholarres.org to the Editorial Office of the Journal of Otology and Rhinology. With Regards, Managing Editor Journal of Otology and Rhinology