Surgical Complexities in Kidney Transplant of a Redo Donor and Recipient: A Case Report

Performing surgery on a previously operated kidney can be difficult and technically demanding. Like re-operative renal surgery, redo donor nephrectomy is also risky, because normal tissue planes are obscured by perinephric fibrosis and adhesions, and dissection of hilar vessels can result in serious vascular damage. Revisiting an aborted implantation site in a recipient is also very demanding, and presence of arterial calcification adds to the difficulty. We report a unique case involving a donor and recipient who had previously proceeded with transplant surgery, but the transplant had been aborted and was then subsequently reattempted with success. We discuss the surgical challenges, as this is the first report of a successful kidney transplant in a recipient with a graft from the same previous donor after a failed first attempt.