Laparoscopic Living-Donor Nephrectomy of a Horseshoe Kidney: A Case Report and Review of the Literature

We present the case of a living-donor nephrectomy of a horseshoe kidney. The recipient was a 33-year-old male with a history of end-stage renal disease secondary to IgA nephropathy. The donor was his 33-year-old partner who on preoperative cross-sectional imaging was found to have a horseshoe kidney with a single artery, vein and ureter. The donor operation was performed using a laparoscopic hand-assisted technique with transection of the interpolar fibrotic band using a stapler device. The backtable organ preparation was performed in a standard fashion with addition of a reinforcing hemostatic suture of the stapled fibrotic band. The donated kidney was transplanted extraperitoneally in the right iliac fossa of the recipient. The patient had an unremarkable postoperative course and was discharged home on post operative day 2 with normalizing renal function. To our knowledge, this is the first living donor nephrectomy of a horseshoe kidney performed using a laparoscopic hand-assisted technique.

Download Full-text

Kidney Autotransplantation for Treatment of Ureteric Obstruction: A Case Report and Brief Review of the Literature

Case Reports in Surgery ◽

10.1155/2021/6646958 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Parth Joshi ◽

Joanne Lin ◽

Tej Sura ◽

Posan S. Limbu ◽

Vatche Melkonian ◽

...

Keyword(s):

Case Report ◽

Living Donor ◽

Iliac Fossa ◽

Kidney Injury ◽

Donor Nephrectomy ◽

Review Of The Literature ◽

Living Donor Nephrectomy ◽

Renal Autotransplantation ◽

The Right ◽

Kidney Autotransplantation

Autologous kidney transplantation is a relatively rare procedure that has been used as an alternative treatment for a variety of complex genitourinary problems, in particular for the treatment of complex proximal ureteral strictures. In this case report, a 47-year-old male, who had undergone a living donor nephrectomy 14 years earlier, presented with episodes of acute kidney injury on chronic kidney disease. He was found to have a complex proximal ureter stricture of his solitary right kidney. He underwent nephrectomy with subsequent autotransplantation of the kidney into the right iliac fossa. His renal function improved significantly after surgery. Renal autotransplantation may be considered for the management of proximal ureteral obstruction when alternative options are contraindicated.

Download Full-text

Changing of the guard? A glance at the surgical representation in the Canadian renal transplantation community

Canadian Urological Association Journal ◽

10.5489/cuaj.3256 ◽

2016 ◽

Vol 10 (1-2) ◽

pp. 7 ◽

Cited By ~ 1

Author(s):

Tom McGregor ◽

Jennifer Bjazevic ◽

Premal Patel ◽

Joshua Koulack

Keyword(s):

Renal Transplant ◽

Deceased Donor ◽

Donor Nephrectomy ◽

Team Approach ◽

Optimal Care ◽

The Past ◽

Living Donor Nephrectomy ◽

Significant Difference ◽

Stage Renal Disease ◽

End Stage

Introduction: Renal transplant is the gold standard treatment for end-stage renal disease (ESRD), and the prevalence of both ESRD and renal transplant has been steadily increasing over the past decade. However, involvement of urology in renal transplant has been declining. We examine the current state of urology involvement in renal transplant programs across Canada.Methods: A telephone survey of all surgical transplant centres in Canada was performed. Information regarding the number of transplant surgeons, their individual training background, and their involvement in specific procedures, including open and laparoscopic living donor nephrectomy, deceased donor nephrectomy, and recipient renal transplant were collected.Results: There are 59 Canadian transplant surgeons, including 27 (46%) who completed a urology residency and 32 (54%) with a general surgery background. With regards to procedures performed, 58 (98%) perform recipient renal transplant surgery, 36 (61%) perform laparoscopic donor nephrectomy, and 17 (29%) perform open donor nephrectomy. There was no significant difference in the number of surgeons that perform renal recipient surgery, laparoscopic or open donor nephrectomies, and deceased donor nephrectomies between surgeons of the two different training backgrounds.Conclusions: The role of urology in Canadian renal transplant has declined significantly over the past decade. Given the medical and surgical complexity of renal transplant, along with the growing need for renal transplants, a multidisciplinary team approach is imperative. Strong urology involvement with the transplant team is crucial for optimal care of these complex patients.

Download Full-text

LAPAROSCOPIC LIVING DONOR NEPHRECTOMY: FEASIBILITY AND FIRST EXPERIENCE IN INDONESIA

Indonesian Journal of Urology ◽

10.32421/juri.v19i2.55 ◽

2012 ◽

Vol 19 (2) ◽

Author(s):

Chaidir A. Mochtar ◽

Irfan Wahyudi ◽

Nur Rasyid ◽

Arry Rodjani ◽

Ponco Birowo ◽

...

Keyword(s):

Living Donor ◽

Left Kidney ◽

Hypertensive Heart Disease ◽

Oral Intake ◽

Operation Time ◽

Donor Nephrectomy ◽

Living Donor Nephrectomy ◽

Estimated Blood Loss ◽

Living Donor Transplantation ◽

Stage Renal Disease

Objective: To report our first experience laparoscopic living donor nephrectomy (LLDN). Material & Method: A 37 year-old man was planned for the living-donor transplantation. The recipient was a 63 year-old man sufferingfrom end stage renal disease, and hypertensive heart disease. The donor and recipient were allowed for positive qualification evaluated preoperatively. We applied a transperitoneal approach for the left kidney. Results: The operation time was 300 minutes and the estimated blood loss was 600 mL. The first warm ischemia time was 15 minutes and 24 seconds. There were no major intraoperative and postoperative complications. The donor began oral intake and mobilization within 10 hours and was hospitalized for 4 days. The recipient’s serum creatinine levels reached near baseline levels (1,5 mg/dL) at day 6. Conclusion: LLDN is technically feasible in Indonesia and may increase the rate of kidney donation in Indonesia due to the minimally invasive nature of the procedure.Keywords: Renal transplantation, laparoscopic living donor nephrectomy, Indonesia.

Download Full-text

Kidney Autotransplantation in a 78-Year-Old Man with Proximal Ureteral Urothelial Carcinoma after Living Donor Nephrectomy

Urologia Internationalis ◽

10.1159/000509445 ◽

2020 ◽

Vol 104 (11-12) ◽

pp. 994-996

Author(s):

Caroline Wacker ◽

Mario Schiffer ◽

Mario Richterstetter ◽

Mirian Opgenoorth ◽

Hendrik Apel

Keyword(s):

Urothelial Carcinoma ◽

Living Donor ◽

Ischemia Reperfusion ◽

Preoperative Staging ◽

Donor Nephrectomy ◽

High Grade ◽

Maximum Serum ◽

Living Donor Nephrectomy ◽

The Right ◽

Kidney Autotransplantation

Six years after living donor nephrectomy to his daughter, the 78-year-old donor presented to the emergency room with anuria for approximately 12 h. Only arterial hypertension, mildly reduced kidney function (eGFR 54 mL/min), and benign prostatic hyperplasia were known as preexisting medical conditions. In sonography, hydronephrosis III° was visible in the right single kidney. Ureterorenoscopy revealed an occlusive tumor in the right proximal ureter, which was treated via double J stent. Biopsy showed focal invasive papillary urothelial carcinoma of G2 high grade. Preoperative staging did not show any signs of lymph node or distant metastases. For therapeutic options, nephroureterectomy with consecutive need for dialysis was discussed versus partial ureteral resection with in situ ureteral reconstruction versus nephroureterectomy with partial ureteral resection and kidney autotransplantation. Eventually, laparoscopic right nephroureterectomy was performed with back-table preparation and tumor resection, followed by ipsilateral autotransplantation. The patient developed postsurgical acute kidney failure due to ischemia/reperfusion with a maximum serum Cr of 5.66 mg/dL (eGFR 10 mL/min), which quickly resolved. The papillary invasive urothelial carcinoma was graded pT1 pTis G2 high grade R0. Regular follow-ups showed no sign for cancer recurrence in computer tomography or cystoscopy; serum Cr was at 1.87 mg/dL (eGFR 53) 12 months after surgery.

Download Full-text

Midline Rotation of the Right Renal Hilum During Hand-Assisted Laparoscopic Living Donor Nephrectomy

JSLS Journal of the Society of Laparoendoscopic Surgeons ◽

10.4293/jsls.2021.00018 ◽

2021 ◽

Vol 25 (2) ◽

pp. e2021.00018

Author(s):

Gaetano Ciancio ◽

Ahmed Farag ◽

Jeffrey J. Gaynor ◽

Mahmoud Morsi ◽

Linda Chen ◽

...

Keyword(s):

Living Donor ◽

Donor Nephrectomy ◽

Living Donor Nephrectomy ◽

Renal Hilum ◽

The Right

Download Full-text

Hereditary thrombophilia and thrombosis of tunneled hemodialysis catheters: A single center study

Journal of Cardiovascular and Thoracic Research ◽

10.34172/jcvtr.2021.06 ◽

2021 ◽

Vol 13 (1) ◽

pp. 79-83

Author(s):

Farzad Kakaei ◽

Saba Mirabolfathi ◽

Negin Yavari ◽

Mohammad Reza Ardalan ◽

Mehrdad Mozafar ◽

...

Keyword(s):

Factor V Leiden ◽

Protein S ◽

Cross Sectional Study ◽

Factor V ◽

Cross Sectional ◽

Mortality And Morbidity ◽

Hereditary Thrombophilia ◽

The Right ◽

Stage Renal Disease ◽

End Stage

Introduction: Vascular access thrombosis increases the risk of mortality and morbidity in end-stage renal disease (ESRD) patients on hemodialysis (HD). This study aimed to evaluate hereditary thrombophilia factors in HD patients and its association with tunneled cuffed catheters’ thrombosis. Methods: In this cross-sectional study, 60 consecutive patients with ESRD on HD with tunneled cuffed catheters were selected. Inherited thrombophilia factors (Anti-thrombin III, Protein C, Protein S, and Factor V Leiden) were measured and the patients were followed for 3 months to evaluate the incidence of catheter-related thrombosis. The association between these factors and catheter thrombosis was assessed. Results: The mean age of patients was 60.30 ± 8.69 years. Forty-seven patients (78.30%) were female and thirteen patients (21.70%) were male. The most common cause of ESRD was diabetes mellitus (41.67%). The most catheter site was the right internal jugular vein (55%). There were 22 (36.67%) and 8 (13.33%) cases of thrombosis and mortality, respectively. The association between hereditary thrombophilia factors and catheter thrombosis was not statistically significant (P > 0.05). Conclusion: In this small group of our patients, the frequency of hereditary thrombophilia was not significantly different between those with and without thrombosis of tunneled HD catheter.

Download Full-text