Surgical Approach to Redo Open Living Donor Nephrectomy via the Same Flank Incision: A Case Report

Living donor nephrectomy is performed with donor safety as the highest priority, and repeat donor nephrectomy through the original incision is rarely reported in transplantation literature. We present the case of a 33-year-old male living kidney donor and a 48-year-old female recipient who underwent scheduled kidney transplantation. The initial procedure was aborted before vascular ligation because the recipient developed intraoperative anaphylactic shock after anesthesia induction. Three weeks later, transplantation was reattempted using the same donor flank incision. Dense retroperitoneal adhesions were encountered, requiring posterior peritoneal dissection to safely expose the renal hilum and surrounding structures. The donor kidney was successfully harvested and transplanted without postoperative complications. This case demonstrates that repeat open donor nephrectomy via the original incision may be feasible with carefully selected patients with a cautious surgical plan and multidisciplinary perioperative management.