Approach to splitting a horseshoe kidney for deceased donor transplantation
Background: The complex anatomy of horseshoe kidneys are associated with high discard rate and poor outcomes, particularly when split for transplantation. We described the surgical approach for en bloc procurement, splitting, and reconstruction of a horseshoe kidney from a deceased donor. Methods: A...
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| Language: | English |
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Elsevier
2025-09-01
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| Series: | Urology Video Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590089725000283 |
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| author | Bruce Li Jirong Lu Patrick P. Luke |
| author_facet | Bruce Li Jirong Lu Patrick P. Luke |
| author_sort | Bruce Li |
| collection | DOAJ |
| description | Background: The complex anatomy of horseshoe kidneys are associated with high discard rate and poor outcomes, particularly when split for transplantation. We described the surgical approach for en bloc procurement, splitting, and reconstruction of a horseshoe kidney from a deceased donor. Methods: A horseshoe kidney with multiple renal arteries and veins was procured bloc from a 27-year-old donor following neurologic brain death. Following en bloc procurement, back-table dissection facilitated vascular, collecting system reconstruction, splitting of the isthmus. The left renal moiety was transplanted into a 31-year-old female with two failed transplants, while the right moiety, with preserved isthmus, was transplanted into a 49-year-old male undergoing his first transplant. Results: Both grafts were transplanted successfully with immediate graft function after a cold ischemia time of 8 h 40 min (left), 13 h 49 min (right). Total surgery times were 3 h 29 min (left), 3 h 37 min (right). Post-operative course was unremarkable, besides one episode of acute pancreatitis managed conservatively for the recipient that received the left moiety. Nine-month follow-up showed excellent graft function in both recipients. Conclusion: Successful transplantation of a split horseshoe kidney requires careful anatomical assessment, precise dissection, and reconstructive techniques. |
| format | Article |
| id | doaj-art-e74b5d3f845d4b0cb7b9ae892be87001 |
| institution | Kabale University |
| issn | 2590-0897 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Urology Video Journal |
| spelling | doaj-art-e74b5d3f845d4b0cb7b9ae892be870012025-08-23T04:48:57ZengElsevierUrology Video Journal2590-08972025-09-012710035310.1016/j.urolvj.2025.100353Approach to splitting a horseshoe kidney for deceased donor transplantationBruce Li0Jirong Lu1Patrick P. Luke2Division of Urology, Department of Surgery, Western University, London, ON, CanadaDivision of Urology, Department of Surgery, Western University, London, ON, Canada; Multi-Organ Transplant Program, London Health Sciences Centre, London, ON, CanadaDivision of Urology, Department of Surgery, Western University, London, ON, Canada; Multi-Organ Transplant Program, London Health Sciences Centre, London, ON, Canada; Corresponding author at: Division of Urology, Western University, University Hospital 339 Windermere Road, London, Ontario N6A 5A5, Canada.Background: The complex anatomy of horseshoe kidneys are associated with high discard rate and poor outcomes, particularly when split for transplantation. We described the surgical approach for en bloc procurement, splitting, and reconstruction of a horseshoe kidney from a deceased donor. Methods: A horseshoe kidney with multiple renal arteries and veins was procured bloc from a 27-year-old donor following neurologic brain death. Following en bloc procurement, back-table dissection facilitated vascular, collecting system reconstruction, splitting of the isthmus. The left renal moiety was transplanted into a 31-year-old female with two failed transplants, while the right moiety, with preserved isthmus, was transplanted into a 49-year-old male undergoing his first transplant. Results: Both grafts were transplanted successfully with immediate graft function after a cold ischemia time of 8 h 40 min (left), 13 h 49 min (right). Total surgery times were 3 h 29 min (left), 3 h 37 min (right). Post-operative course was unremarkable, besides one episode of acute pancreatitis managed conservatively for the recipient that received the left moiety. Nine-month follow-up showed excellent graft function in both recipients. Conclusion: Successful transplantation of a split horseshoe kidney requires careful anatomical assessment, precise dissection, and reconstructive techniques.http://www.sciencedirect.com/science/article/pii/S2590089725000283Transplantation, kidneyOrgan donation, donor selection, horseshoe |
| spellingShingle | Bruce Li Jirong Lu Patrick P. Luke Approach to splitting a horseshoe kidney for deceased donor transplantation Urology Video Journal Transplantation, kidney Organ donation, donor selection, horseshoe |
| title | Approach to splitting a horseshoe kidney for deceased donor transplantation |
| title_full | Approach to splitting a horseshoe kidney for deceased donor transplantation |
| title_fullStr | Approach to splitting a horseshoe kidney for deceased donor transplantation |
| title_full_unstemmed | Approach to splitting a horseshoe kidney for deceased donor transplantation |
| title_short | Approach to splitting a horseshoe kidney for deceased donor transplantation |
| title_sort | approach to splitting a horseshoe kidney for deceased donor transplantation |
| topic | Transplantation, kidney Organ donation, donor selection, horseshoe |
| url | http://www.sciencedirect.com/science/article/pii/S2590089725000283 |
| work_keys_str_mv | AT bruceli approachtosplittingahorseshoekidneyfordeceaseddonortransplantation AT jironglu approachtosplittingahorseshoekidneyfordeceaseddonortransplantation AT patrickpluke approachtosplittingahorseshoekidneyfordeceaseddonortransplantation |