Renal-portal vein shunt for renal failure after left renal vein ligation in children: a review.
OBJECTIVE
Interruption of the inferior vena cava and left renal vein in the patient with a solitary left kidney without permanent renal damage has been reported in the past. We assess the risks of similar venous interruption in children and establish guidelines for the management of those cases when collateral drainage of the kidney is uncertain.


METHODS
We compared our case with a review of all previous reports in the literature concerning ligation of the vena cava and left renal vein in patients with a solitary left kidney.


RESULTS
Ligation of the left renal vein in an isolated left kidney in children has been shown to carry the risk of significant renal damage. Renal-portal vein shunt provided adequate drainage of the left kidney after inferior vena caval ligation in our case.


CONCLUSIONS
While there have been reported cases of successful inferior vena cava or left renal vein ligation in the isolated left kidney with good renal function, adequate renal drainage should be established in cases where collateral drainage is uncertain, especially in children. Renal-portal vein shunt is a viable therapeutic option to establish left renal drainage in select circumstances.
Koyle
M A
MA
Department of Surgery, Children's Hospital, Denver, Colorado, USA.
Karrer
F M
FM
Mahoney
A C
AC
D000714:Anastomosis, Surgical / Q000379:methods; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008026:Ligation; D011169:Portal Vein / Q000601:surgery*; D051437:Renal Insufficiency / Q000601:surgery*; D012082:Renal Veins / Q000601:surgery*; D012307:Risk Factors; D014656:Vascular Surgical Procedures / Q000379:methods