Laparoscopic hand-assisted donor heminephrectomy in living donor with horseshoe kidney. Case study

B. Baimakhanov, A. Chormanov, I. Madadov, E. Belgibaev, E.S. Nabiev, Zh.M. Syrymov, B.G. Rgebaev, N. Saduakas, I. Sagatov
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Abstract

Report of our clinical case of laparoscopic hand-assisted donor heminephrectomy in living donor with horseshoe kidney (Horseshoe kidne) has a good innovation in donor kidney retrieval technique and particularly in case of congenital anomalies. Kidney transplantation is a “gold standard” of treatment of chronic kidney disease in terminal stage. Nowadays there is a strong deficit of donor organs. Due to undeveloped cadaveric kidney transplantation we always try to accept donors with different anatomic particularities. In our practice we perform traditionally laparoscopic hand-assisted donor nephrectomy either in case of single artery and vein or multiple vessels. This case is a report of kidney transplantation from 65 –years old woman for her 39-years old son with end-stage renal disease (ESRD). Technical challenge was due to that donor had a Horseshoe kidne with parenchymal isthmus, with 4 arteries on right half and 2 arteries on the left with retrocaval position of the latters. We performed literature review for similar cases and found out that usually open laparotomy was performed in this patients. So we decided not to change the familiar for us technique in this case also. Donor underwent laparoscopic hand-assisted donor heminephrectomy with subsequent successful implantation of graft and immediate function.
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腹腔镜手辅助马蹄肾活体供者半肾切除术。案例研究
本文报道了腹腔镜手辅助马蹄肾活体供体半肾切除术的临床病例,在供肾回收技术上有很好的创新,特别是在先天性异常的情况下。肾移植是治疗晚期慢性肾病的“金标准”。现在供体器官严重缺乏。由于尸体肾移植的不成熟,我们总是尝试接受具有不同解剖特征的供体。在我们的实践中,我们进行传统的腹腔镜手辅助供体肾切除术,无论是单动脉和静脉或多血管。这是一个65岁的妇女为她39岁的终末期肾病(ESRD)的儿子进行肾移植的病例报告。技术上的挑战是由于供者的马蹄肾有实质峡部,右半部分有4条动脉,左侧有2条动脉,后者位于腔后位置。我们对类似病例进行了文献回顾,发现该患者通常采用开腹手术。所以我们决定在这种情况下也不改变我们熟悉的技术。供体行腹腔镜手辅助供体半肾切除术,移植成功,即刻恢复功能。
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