Strategies for Transplantation of Cadaveric Kidneys With Congenital Fusion Anomalies

Uzzo, Robert G.; Hsu, Thomas H.S.; Goldfarb, David A.; Taylor, Rodney J.; Novick, Andrew C.; Gill, Inderbir S.

doi:10.1016/s0022-5347(05)66520-2

Cited by 16 publications

(16 citation statements)

References 18 publications

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“…Furthermore, the thickness of the isthmic parenchyma and the presence of the collecting system inside influence the decision because splitting can lead to urinary fistula or postoperative bleeding [6,7].…”

Section: Discussionmentioning

confidence: 99%

Maximizing Nephron Mass in Horseshoe Kidney Transplantation Using Inferior Epigastric Artery: Case Report

Elec¹,

Zaharie²,

Vintilă³

et al. 2018

Urol Int

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Due to the progressive shortage of donors, kidneys with congenital anomalies are considered for transplantation. We report a successful transplantation of a split horseshoe kidney from a deceased donor by using the inferior epigastric artery with an end-to-end anastomosis, supplying the isthmus. Thus, we preserved as much as possible the functional parenchyma for a good long-term outcome. The learning point is that the use of the right inferior epigastric artery seems to be a good solution to perfuse the lower artery in order to avoid its ligation, thus reducing the nephron mass of the graft.

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Section: Discussionmentioning

confidence: 99%

Maximizing Nephron Mass in Horseshoe Kidney Transplantation Using Inferior Epigastric Artery: Case Report

Elec¹,

Zaharie²,

Vintilă³

et al. 2018

Urol Int

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“…Most of donors with congenital anomalies are asymptomatic patients (5). History of urinary tract infections, lithiasis or hematuria should be evaluated (6). If confirmed, radiological evaluation with CT with vascular and urinary reconstruction is mandatory.…”

Section: Discussionmentioning

confidence: 99%

Horseshoe Kidney Transplantation: An Underpowered Source for Kidney Allografts, Review and Case Report

et al. 2017

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Transplantation of kidneys with anatomical variations like horseshoe kidneys is underused. Shortage of organs should make surgeons explore alternatives to using this type of allografts. A review of current literature, focused on the evaluation of these organs and surgical technique was performed. Our experience with two cases is presented, describing surgical technique and management of local complications. Results at long term follow-up are reported and compared with available series . Transplantation of horseshoe kidneys is technically feasible, with optimal results at follow-up. Evaluation of this kind of organs is necessary to increase the pool of kidneys available for transplantation. However, anatomic and surgical details should be considered and experienced transplantation teams must assume this type of surgery.

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“…This technique is recommended when broad, multiple veins are present branching from the vena cava [14]. Because of limited information on preparing horseshoe kidneys for transplantation on the "back table" and also for the technical challenges of transplanting them, Uzzo et al published an algorythm for the evaluation and utilization of horseshoe kidneys for transplantation [15]. Kidneys with a thick isthmus and a wide parenchymal bridge are recommended for transplantation en bloc [13].…”

Section: Discussionmentioning

confidence: 99%

Horseshoe kidney transplantation

Nemes

Kanyári

Zádori

et al. 2015

IMAS

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Abstract:Horseshoe kidney is a fusion anomaly found in approximately one in 400-600 people. Due to vascular and ureteral variations, transplantation with a horseshoe kidney presents a technical challenge. In our case, the isthmus connected the upper poles and contained parenchyma. It consisted of three renal arteries, fi ve veins collected to the inferior vena cava, and two ureters and pyelons. It was implanted en bloc to the left side retroperitoneally. During the early period, cellular and humoral rejection was confi rmed and treated. For a urine leak, double J catheters were implanted into both ureters. Later, the fi rst catheter was removed. Subsequently, urinary sepsis developed, necessitating graftectomy. The uncommon anatomy of ureters and antibody-mediated rejection (AMR) may both be factors for a ureter tip necrosis led to an infected urinoma. After other Hungarian authors, we also report a horseshoe kidney transplantation that was technically successful. However, after an adequately treated but severe acute humoral rejection, the patient developed sepsis, and the kidney had to be removed. We conclude that transplantation with horseshoe kidney is technically feasible but may increase the risk for urinary complications and resultant infections. Careful consideration of risk and benefi t is advised when a transplant professional is faced with this option.

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Strategies for Transplantation of Cadaveric Kidneys With Congenital Fusion Anomalies

Cited by 16 publications

References 18 publications

Maximizing Nephron Mass in Horseshoe Kidney Transplantation Using Inferior Epigastric Artery: Case Report

Maximizing Nephron Mass in Horseshoe Kidney Transplantation Using Inferior Epigastric Artery: Case Report

Horseshoe Kidney Transplantation: An Underpowered Source for Kidney Allografts, Review and Case Report

Horseshoe kidney transplantation

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