Horseshoe kidney for transplantation: technical considerations.

Area of Science:

• Nephrology
• Transplant Surgery
• Urology

Background:

• Cadaver organ shortage necessitates utilizing atypical organs like horseshoe kidneys for transplantation.
• Experience with horseshoe kidney transplantation is limited due to its low prevalence.

Observation:

• A 58-year-old male patient with chronic glomerulonephritis and renal failure underwent transplantation.
• The horseshoe kidney featured a thick isthmus, suggesting complex urinary collecting and intrarenal vessel systems.

Findings:

• The horseshoe kidney was transplanted en bloc to manage its complex anatomy.
• Meticulous vessel length, positioning (especially venous drainage), and intraperitoneal placement prevented complications like kinking and thrombosis.
• Renal veins were transected without a vena cava patch, resolving potential issues.

Implications:

• En bloc transplantation of horseshoe kidneys is feasible and can be successful with careful surgical planning.
• Individualized surgical strategies are essential for managing the unique anatomical challenges of horseshoe kidneys.
• This approach expands the donor pool and offers hope for patients with end-stage renal disease.