Justo-Janeiro JM, Orozco EP, Reyes FJRE, de la Rosa Paredes R, de Lara Cisneros LGV, Espinosa AL, Naylor JM. Transplantation of a horseshoe kidney from a living donor: Case report, long term outcome and donor safety.
Int J Surg Case Rep 2015;
15:21-5. [PMID:
26299249 PMCID:
PMC4601952 DOI:
10.1016/j.ijscr.2015.08.008]
[Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 08/05/2015] [Indexed: 11/25/2022] Open
Abstract
Horseshoe kidney is the most common urinary congenital abnormality.
We describe a successful transplantation of a horseshoe kidney from a living donor.
We emphasized the absence of other abnormalities and establish a low surgical risk.
Good long term donor and recipient́s outcomes have been described.
Introduction
The use of a horseshoe kidney in renal transplant remains controversial, when it is found in the evaluation of a living donor, anatomical, surgical and ethical issues are involved.
Presentation of Case
An uncomplicated horseshoe kidney was detected in a 51-year-old woman who was the only suitable donor for her 30-year-old son. Kidneys were fused in the inferior pole and no vascular or urinary abnormalities were detected during imaging evaluation. The surgical procedure was approved by the hospital transplant committee. A laparotomy was performed by means of a medial upper incision. The isthmus of the kidney was divided using a harmonic scalpel and the left segment was used; it had 2 arteries too distant to create a common one, thus anastomosed separately. The renal vein was side-to-side anastomosed to the right external iliac vein and a Lich-Gregoir ureteral implant was made. There were no intraoperative or postoperative complications in the donor who currently remains asymptomatic. Recipient developed a delayed graft function (DGF), and was discharged on the 12th day after surgery. After 24 months of surgery, renal function has remained stable with a serum creatinine of 128 μmol/L (1.45 mg/dL).
Discussion
There are 7 reports of a horseshoe kidney from living donors in 8 patients without morbidity and a good long term outcome of all recipients.
Conclusion
If we anticipate a low operative risk and there is a suitable anatomy, we may consider the use of horseshoe kidneys from living donors a viable alternative.
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