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Transplantation of a horseshoe kidney found during harvest operation of a cadaveric donor: a case report.

Yun S, Woo HD, Doo SW, Kwon SH, Noh H, Song D - J. Korean Med. Sci. (2014)

Bottom Line: Resistive index was 0.72.Glomerular filtration ratio was 84.69 mL/min on postoperative day 14.The horseshoe kidney can be successfully transplanted and could be a good solution for the shortage of organ donors.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea.

ABSTRACT
A 34-yr-old female was diagnosed as being brain dead. Preoperative ultrasound revealed no abnormal focal lesions. However, the horseshoe kidney was identified during organ harvest. En bloc nephrectomy was performed. The kidney was divided at the midline of isthmus. The divided right kidney was discarded due to numerous arteries and veins. The divided left kidney was transplanted. After declamping, the kidney was well perfused and started clearing. Resistive index was 0.72. Glomerular filtration ratio was 84.69 mL/min on postoperative day 14. The horseshoe kidney can be successfully transplanted and could be a good solution for the shortage of organ donors.

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Post-operative images and functions. (A) Renal doppler ultrasound at postoperative day 1. Size of the transplanted kidney was 11.2×4.3 cm. Parenchymal echogenicity was increased. RI index was 0.72. No abnormal pulsation wave was found. (B) DTPA-GFR results at postoperative 14 days. Normal concentration, but slight delayed excretion with calyectasis of transplanted kidney is seen. GFR of transplanted kidney was improved to 84.69 mL/min from 66.16 mL/min of postoperative 7 days. (C, D) Non-enhanced abdominal CT scan at postoperative one month. Transplanted kidney showed mild hydronephrosis with no definite evidence of radiopaque stone or dilatation of ureter.
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Figure 2: Post-operative images and functions. (A) Renal doppler ultrasound at postoperative day 1. Size of the transplanted kidney was 11.2×4.3 cm. Parenchymal echogenicity was increased. RI index was 0.72. No abnormal pulsation wave was found. (B) DTPA-GFR results at postoperative 14 days. Normal concentration, but slight delayed excretion with calyectasis of transplanted kidney is seen. GFR of transplanted kidney was improved to 84.69 mL/min from 66.16 mL/min of postoperative 7 days. (C, D) Non-enhanced abdominal CT scan at postoperative one month. Transplanted kidney showed mild hydronephrosis with no definite evidence of radiopaque stone or dilatation of ureter.

Mentions: Immunosuppressants were given according to a routine protocol. Doppler ultrasound showed well-perfused parenchyma. Resistive index was 0.72 (Fig. 2A). A technetium 99m-diethylene triamine pentaacetic acid (99mTc-DTPA) renal scan on postoperative day 7 was normal with no leak from the divided isthmus. The glomerular filtration ratio (GFR) of the transplanted kidney was 66.2 mL/min on postoperative day 7 and improved to 84.69 mL/min on postoperative day 14 (Fig. 2B). Creatinine dropped to 0.94 on the postoperative day 9. The recipient had an uneventful recovery (Fig. 2C, D). The transplanted kidney has been functioning well up to the point of this report (12 months after transplantation).


Transplantation of a horseshoe kidney found during harvest operation of a cadaveric donor: a case report.

Yun S, Woo HD, Doo SW, Kwon SH, Noh H, Song D - J. Korean Med. Sci. (2014)

Post-operative images and functions. (A) Renal doppler ultrasound at postoperative day 1. Size of the transplanted kidney was 11.2×4.3 cm. Parenchymal echogenicity was increased. RI index was 0.72. No abnormal pulsation wave was found. (B) DTPA-GFR results at postoperative 14 days. Normal concentration, but slight delayed excretion with calyectasis of transplanted kidney is seen. GFR of transplanted kidney was improved to 84.69 mL/min from 66.16 mL/min of postoperative 7 days. (C, D) Non-enhanced abdominal CT scan at postoperative one month. Transplanted kidney showed mild hydronephrosis with no definite evidence of radiopaque stone or dilatation of ureter.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4129212&req=5

Figure 2: Post-operative images and functions. (A) Renal doppler ultrasound at postoperative day 1. Size of the transplanted kidney was 11.2×4.3 cm. Parenchymal echogenicity was increased. RI index was 0.72. No abnormal pulsation wave was found. (B) DTPA-GFR results at postoperative 14 days. Normal concentration, but slight delayed excretion with calyectasis of transplanted kidney is seen. GFR of transplanted kidney was improved to 84.69 mL/min from 66.16 mL/min of postoperative 7 days. (C, D) Non-enhanced abdominal CT scan at postoperative one month. Transplanted kidney showed mild hydronephrosis with no definite evidence of radiopaque stone or dilatation of ureter.
Mentions: Immunosuppressants were given according to a routine protocol. Doppler ultrasound showed well-perfused parenchyma. Resistive index was 0.72 (Fig. 2A). A technetium 99m-diethylene triamine pentaacetic acid (99mTc-DTPA) renal scan on postoperative day 7 was normal with no leak from the divided isthmus. The glomerular filtration ratio (GFR) of the transplanted kidney was 66.2 mL/min on postoperative day 7 and improved to 84.69 mL/min on postoperative day 14 (Fig. 2B). Creatinine dropped to 0.94 on the postoperative day 9. The recipient had an uneventful recovery (Fig. 2C, D). The transplanted kidney has been functioning well up to the point of this report (12 months after transplantation).

Bottom Line: Resistive index was 0.72.Glomerular filtration ratio was 84.69 mL/min on postoperative day 14.The horseshoe kidney can be successfully transplanted and could be a good solution for the shortage of organ donors.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea.

ABSTRACT
A 34-yr-old female was diagnosed as being brain dead. Preoperative ultrasound revealed no abnormal focal lesions. However, the horseshoe kidney was identified during organ harvest. En bloc nephrectomy was performed. The kidney was divided at the midline of isthmus. The divided right kidney was discarded due to numerous arteries and veins. The divided left kidney was transplanted. After declamping, the kidney was well perfused and started clearing. Resistive index was 0.72. Glomerular filtration ratio was 84.69 mL/min on postoperative day 14. The horseshoe kidney can be successfully transplanted and could be a good solution for the shortage of organ donors.

Show MeSH
Related in: MedlinePlus