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Transplantation of a horseshoe kidney from a living donor: Case report, long term
outcome and donor safety
#MMPMID26299249
Justo-Janeiro JM
; Orozco EP
; Reyes FJ
; de la Rosa Paredes R
; de Lara Cisneros LG
; Espinosa AL
; Naylor JM
Int J Surg Case Rep
2015[]; 15
(?): 21-5
PMID26299249
show ga
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?mol/L (1.45mg/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.