title: Laparoscopic approach for an intra-abdominal kidney allograft nephrectomy after pediatric transplantation: a case report.
abstract: We report a case of minimally invasive nephrectomy of a kidney transplanted into the abdominal cavity in a child. A 15-year-old girl underwent transplantation with a cadaveric donor kidney due to congenital pyelonephritis, vesicoureteral reflux, and secondary bladder atrophy. The transplant was complicated by hyperacute rejection, cytomegalovirus infection, and anastomotic stenosis of the Bricker neobladder. After recurrent urinary tract infections, the patient was reintroduced to hemodialysis in 2010. After pneumo-peritoneum, we placed 2 10-mm trocars in the hypochondrium and left side and 2 5-mm in the left iliac fossa and right upper quadrant. The transplanted kidney was skeletonized, the artery and vein were cut to the end-to-side anastomoses to the juxta-renal aorta and cava using an automatic 35-mm, stapler, and the ureter was dissected and closed with clips. Via a Pfannestiel minilaparotomy we extracted the allograft. The patient was discharged on the third postoperative day. After 4 months of follow-up, she is alive an on dialysis. Laparoscopic nephrectomy of a kidney transplanted into the abdominal cavity is feasible and safe in centers with skilled minimally invasive techniques.
authors.affiliation: Department of Abdominal and Transplantation Surgery, Mediterranean Institute for Transplantation and Advanced Specialized Therapies, University of Pittsburgh Medical Center in Italy, Palermo, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Pagano
authors.forename: D
authors.initials: D
authors.lastname: Cintorino
authors.forename: S
authors.initials: S
authors.lastname: Li Petri
authors.forename: F
authors.initials: F
authors.lastname: di Francesco
authors.forename: C
authors.initials: C
authors.lastname: Ricotta
authors.forename: J
authors.initials: J
authors.lastname: Argento
authors.forename: G J
authors.initials: GJ
authors.lastname: Echeverri
authors.forename: T
authors.initials: T
authors.lastname: Bertani
authors.forename: S
authors.initials: S
authors.lastname: Riva
authors.forename: B G
authors.initials: BG
authors.lastname: Gridelli
authors.forename: M
authors.initials: M
authors.lastname: Spada
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy; D009392:Nephrectomy / Q000379:methods*