Horseshoe kidney transplantation: an overview

Area of Science:

• Nephrology
• Urology
• Transplantation Surgery

Background:

• Horseshoe kidney is the most common congenital renal anomaly, characterized by fusion of the kidneys, typically at the lower poles.
• This anomaly presents significant anatomical variations in renal vasculature and collecting systems.
• Understanding these variations is crucial for successful surgical management and transplantation.

Purpose of the Study:

• To review the outcomes of horseshoe kidney transplantation.
• To assess the feasibility and success rates of transplanting horseshoe kidneys, either en bloc or divided.
• To highlight the importance of technical considerations in horseshoe kidney transplantation.

Main Methods:

• A literature review was conducted, analyzing case histories of horseshoe kidney transplantation published between 1975 and 1998.
• Data on transplantation strategies (en bloc vs. divided), graft function, and complications were extracted.
• Success rates and mean follow-up periods were calculated.

Main Results:

• Thirty-one case histories were reviewed, involving 48 recipients.
• Nineteen grafts (41%) demonstrated immediate function, and 21 (46%) showed delayed function.
• The overall success rate was 87%, with a mean follow-up of 22 months; 13% of grafts experienced non-function due to thrombosis or rejection.

Conclusions:

• Horseshoe kidney transplantation yields good results when specific technical details are meticulously addressed.
• Given the scarcity of organ donors, horseshoe kidneys represent a valuable resource for renal transplantation.
• Careful pre-operative assessment and surgical planning are essential for optimizing outcomes in horseshoe kidney recipients.