Renal Transplantation From a Living Donor With a Horseshoe Kidney

Каабак, М. М.; Бабенко, Н. Н.; Зокоев, А. К.; Khovrin, V. V.; Galyan, Т. N.

doi:10.1097/txd.0000000000000564

Cited by 8 publications

(4 citation statements)

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“…Electronic databases were searched for case reports of transplantation of the horseshoe kidneys from 1975 to April 2022. There were 131 pairs of horseshoe kidneys, which were procured worldwide [44][45][46][47][48][49]. Fifty-three pairs of horseshoe kidneys were transplanted en bloc to a single recipient, and 78 pairs were divided at the isthmus with their blood supply separated and transplanted as single units to 131 recipients.…”

Section: Methodsmentioning

confidence: 99%

Transplantation of the Horseshoe Kidneys: A Model for Dual Adult Kidney Transplantation

Nghiem

2022

Uro

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Background: The shortage of organs has called for the use of two marginal adult kidneys (MAKs) with a low nephron mass as dual adult kidneys transplanted to a single recipient. The operative techniques of the transplantation of these kidneys are still debated. Since the horseshoe kidneys have been transplanted as early as 1975, it is theorized that the technique of the en bloc transplantation of the horseshoe kidney may be applied to the MAKs. Material and Methods: The world literature search during the period 1975–2021 on the use of deceased-donor horseshoe kidneys was reviewed. The selection of the donors, the anatomy of the kidneys, the principles of organ recovery, the transplantation procedure, and the results were discussed. Finally, this technique of en bloc transplantation was applied successfully to seven pairs of MAKs and is described herein. The dual adult kidneys were simultaneously vascularized by the donor aorta and vena cava, which were anastomosed, respectively, to the recipient iliac artery and vein. Results: A total of 131 case reports of deceased horseshoe kidney donors were reviewed, of which 53 en bloc kidneys were transplanted successfully to a single recipient, and the remaining 78 were divided and transplanted as single units to 131 recipients. Twenty-five single kidneys were discarded. At the time of publication, all horseshoe kidneys had a good renal function. In the series of seven pairs of MAKs transplanted en bloc, the operative time was 3 h. There were no primary nonfunctions, no vascular thromboses, no urinary leakages, and no wound infections. Only two patients required temporary dialysis despite an average of 28.4 h of cold ischemia time. No hydronephrosis and lymphocele was experienced. Both patient and graft survival were 100%. At the time of follow-up at 36 months, serum creatinine levels averaged 1.8 mg/dL (range 1.4–1.9). Conclusions: This technique of en bloc renal transplantation using the donor aorta and vena cava for revascularization can be applied to both the horseshoe kidneys and the MAK, and improve organ utilization.

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Section: Methodsmentioning

confidence: 99%

Transplantation of the Horseshoe Kidneys: A Model for Dual Adult Kidney Transplantation

Nghiem

2022

Uro

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“…В России применение безстероидного протокола иммуносупрессии началось в 2006 г. [9], отдаленные результаты показали его преимущества перед стандартными режимами [10].…”

Section: актуальностьunclassified

The course of the novel coronavirus infection COVID-19 in recipients of solid organs, depending on the type of maintenance immunosuppression according to the local transplant register

Каабак¹,

Rappoport²

2021

Clinical and Experimental Surgery. Petrovsky journal

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КЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ ХИРУРГИЯАктуальность. Новая коронавирусная инфекция COVID-19 оказала значительное влияние на трансплантацию органов в мире как за счет снижения доступности посмертных донорских органов вследствие перегруженности реанимационных отделений пациентами с вирусной пневмонией, так и за счет тяжелого течения инфекции у пациентов после трансплантации, обусловленного поддерживающей иммуносупрессией. Состав поддерживающей иммуносупрессии у пациента после трансплантации может оказывать влияние на течение коронавирусной инфекции. Цель -на основании анализа локального трансплантационного регистра определить влияние состава поддерживающей иммуносупрессии на течение COVID-19 у реципиентов донорских органов. Материал и методы. В марте 2020 г. в связи с пандемией COVID-19 в модули регистра введены дополнительные блоки, характеризующие течение COVID-19 у пациента. Аналитический раздел регистра позволяет сравнивать результаты трансплантации в выборках пациентов, произвольно формируемых исследователем. Ежедневное обновление данных дает возможность анализировать актуальные сведения. Проведен анализ исходов COVID-19 у реципиентов донорских органов в зависимости от состава поддерживающей иммуносупрессии. Результаты. С февраля 2020 г. по апрель 2021 г. регистр выявил 72 реципиента с COVID-19, из них 41 получали иммуносупрессию без стероидов. Выздоровели 93% пациентов без стероидов и 48% пациентов на стероидах, смертность составила 5% против 42%, потеряли трансплантат 2% против 10%. Заключение. Трансплантационный регистр, существующий в правовом поле российского законодательства, учитывающий сведения о выполненных в конкретных медицинских центрах конкретным пациентам трансплантациях, их эффективности, включая практику их реабилитации и медикаментозного сопровождения, позволяет своевременно выявлять успешные практики, в том числе в новых условиях, возникших в связи с пандемией COVID-19. Поддерживающая иммуносупрессия без стероидов сопровождается значительным увеличением шансов благоприятного исхода COVID-19 у реципиентов солидных органов.Финансирование. Исследование не имело спонсорской поддержки.Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

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“…A horseshoe kidney (HSK) is the most frequent renal fusion anomaly (1 in 400 to 800) [1][2][3][4][5][6][7][8][9][10] that involves abnormal migration of both kidneys with concomitant polar fusion. In over 90% of the cases this fusion occurs at the lower poles and as a result, two separate excretory renal units are maintained.…”

Section: Introductionmentioning

confidence: 99%

“…Due to all of this, concern for safety and feasibility of a living donor HSK has been questioned. However, according to the literature, since 1998, ten cases of successful HSK transplantation from live donors have been published (9 out of 10 from countries where deceased donation is not available) [1,11]. Outcomes are comparable with standard non-HSK donation with the most common complication reported being urinary leaks, likely due to the anterior situation of the urinary pelvis and the transected renal parenchyma [2,4,5,11].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Living-Donor Nephrectomy of a Horseshoe Kidney: A Case Report and Review of the Literature

et al. 2021

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We present the case of a living-donor nephrectomy of a horseshoe kidney. The recipient was a 33-year-old male with a history of end-stage renal disease secondary to IgA nephropathy. The donor was his 33-year-old partner who on preoperative cross-sectional imaging was found to have a horseshoe kidney with a single artery, vein and ureter. The donor operation was performed using a laparoscopic hand-assisted technique with transection of the interpolar fibrotic band using a stapler device. The backtable organ preparation was performed in a standard fashion with addition of a reinforcing hemostatic suture of the stapled fibrotic band. The donated kidney was transplanted extraperitoneally in the right iliac fossa of the recipient. The patient had an unremarkable postoperative course and was discharged home on post operative day 2 with normalizing renal function. To our knowledge, this is the first living donor nephrectomy of a horseshoe kidney performed using a laparoscopic hand-assisted technique.

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Renal Transplantation From a Living Donor With a Horseshoe Kidney

Cited by 8 publications

References 5 publications

Transplantation of the Horseshoe Kidneys: A Model for Dual Adult Kidney Transplantation

Transplantation of the Horseshoe Kidneys: A Model for Dual Adult Kidney Transplantation

The course of the novel coronavirus infection COVID-19 in recipients of solid organs, depending on the type of maintenance immunosuppression according to the local transplant register

Laparoscopic Living-Donor Nephrectomy of a Horseshoe Kidney: A Case Report and Review of the Literature

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