Transplanting a horseshoe kidney: A case report and review of surgical strategies

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.

Horseshoe kidney splitting technique for transplantation

Shortage of donors has led to an expansion of the criteria for acceptability of deceased-donor organs including the use of kidneys with anatomical variations such us horseshoe kidneys (HSKs). Transplantation can be accomplished either en bloc or after division of the HSK. Little is known about the most appropriate technique to split the kidney and minimize risk of bleeding or urinary fistula. In this report we present two renal transplants after division of a HSK with a different splitting technique.