Multiorgan retrieval and horseshoe kidney: case report

Area of Science:

• Surgical techniques
• Transplantation medicine
• Anatomical variations

Background:

• Horseshoe kidney is a common congenital anomaly where kidneys fuse at the lower poles, typically positioning the fused organ anterior to the aorta.
• Organ retrieval for transplantation involves cannulating major abdominal vessels (aorta and vena cava) below the renal arteries to perfuse preservation solution.
• Standard cannulation techniques can be hazardous in patients with horseshoe kidney due to altered anatomy.

Observation:

• The anterior surface of the aorta is typically obscured by the fused horseshoe kidney.
• Standard cannulation below the renal vessels may be difficult or impossible in the presence of a horseshoe kidney.

Findings:

• A novel surgical maneuver was developed to safely expose the anterior aortic surface for cannulation.
• The technique involves transecting the horseshoe kidney midline using a linear cutter stapler after ligating both kidney pedicles.
• This method successfully facilitated aorta cannulation without requiring access through the iliac vessels.

Implications:

• This technique offers a safe and effective solution for organ retrieval in patients with horseshoe kidney.
• It potentially reduces operative risks and improves outcomes in multiorgan transplantation.
• The described maneuver may be adaptable for other surgical procedures involving the abdominal aorta in the presence of horseshoe kidney.