Experiences and outcomes of inverted kidney transplantation from a single Vietnamese institute.

Background: Inverted kidney transplant (KT) has been applied in many transplant centers, but the experiences and outcomes of this technique was limited.

Aim: To describe the technical characteristics, indications and evaluate the outcomes of inverted kidney transplantation.

Methods: Retrospective study from January 2016 to December 2023, included 74 patients who underwent inverted kidney transplantation with 72 cases of right kidney transplant into the right iliac fossa and 2 cases of left kidney transplant into the left iliac fossa performed in Viet Duc University Hospital.

Results: 63 cases in stage 1 (ipsilateral kidney transplant), all kidney graft were transplanted on the same side and 11 cases in stage 2 in which the kidney transplant was performed in some special cases such as recipients with severe atherosclerotic iliac arteries or incompatibility between the arteries and venous. The operation time was significantly higher (192.8 vs. 173.7 min, p = 0.037). However, the kidney function showed no difference when being discharged and remained stable until the latest follow-up. 3-year graft survival was 98.3%. There was 1 case of graft loss due to chronic graft rejection- immunosuppression incompliance requiring retransplantation after 2 years. Main complications included acute pancreatitis (2.7%), and ureteral stenosis at the ureter-bladder junction (6.8%), not significantly different compared to conventional KT.

Conclusion: Inverted kidney transplantation is a simple, safe and effective technique and could be a feasible solution for some specific circumstances.