title: Transplantation of a horseshoe kidney from a living donor: Case report, long term outcome and donor safety.
abstract: BACKGROUND
  The use of a horseshoe kidney in renal transplant remains controversial, when it is found in the evaluation of a living donor, anatomical, surgical and ethical issues are involved.
  
  
  METHODS
  An uncomplicated horseshoe kidney was detected in a 51-year-old woman who was the only suitable donor for her 30-year-old son. Kidneys were fused in the inferior pole and no vascular or urinary abnormalities were detected during imaging evaluation. The surgical procedure was approved by the hospital transplant committee. A laparotomy was performed by means of a medial upper incision. The isthmus of the kidney was divided using a harmonic scalpel and the left segment was used; it had 2 arteries too distant to create a common one, thus anastomosed separately. The renal vein was side-to-side anastomosed to the right external iliac vein and a Lich-Gregoir ureteral implant was made. There were no intraoperative or postoperative complications in the donor who currently remains asymptomatic. Recipient developed a delayed graft function (DGF), and was discharged on the 12th day after surgery. After 24 months of surgery, renal function has remained stable with a serum creatinine of 128μmol/L (1.45mg/dL).
  
  
  CONCLUSIONS
  There are 7 reports of a horseshoe kidney from living donors in 8 patients without morbidity and a good long term outcome of all recipients.
  
  
  CONCLUSIONS
  If we anticipate a low operative risk and there is a suitable anatomy, we may consider the use of horseshoe kidneys from living donors a viable alternative.
authors: Department of Surgery, Angeles Hospital of Puebla, 2143 Kepler Street, Atlixcáyotl, Puebla 72190, Puebla, Mexico; Faculty of Medicine, Autonomous University of Puebla, 2902 South 13th Street, Volcanes, Puebla, Puebla, Mexico. Electronic address: jaime_justo@icloud.com.
authors: Jaime Manuel
authors: JM
authors: Justo-Janeiro
authors: Department of Surgery, Angeles Hospital of Puebla, 2143 Kepler Street, Atlixcáyotl, Puebla 72190, Puebla, Mexico.
authors: Eduardo Prado
authors: EP
authors: Orozco
authors: Department of Surgery, Angeles Hospital of Puebla, 2143 Kepler Street, Atlixcáyotl, Puebla 72190, Puebla, Mexico.
authors: Francisco J Roberto Enríquez
authors: FJ
authors: Reyes
authors: Department of Surgery, Angeles Hospital of Puebla, 2143 Kepler Street, Atlixcáyotl, Puebla 72190, Puebla, Mexico.
authors: René
authors: R
authors: de la Rosa Paredes
authors: Department of Anesthesia, Angeles Hospital of Puebla, 2143 Kepler Street, Atlixcáyotl, Puebla 72190, Puebla, Mexico.
authors: Luis G Vázquez
authors: LG
authors: de Lara Cisneros
authors: Department of Anesthesia, Angeles Hospital of Puebla, 2143 Kepler Street, Atlixcáyotl, Puebla 72190, Puebla, Mexico.
authors: Alfonso Lozano
authors: AL
authors: Espinosa
authors: Department of Nephrology, Angeles Hospital of Puebla, 2143 Kepler Street, Atlixcáyotl, Puebla 72190, Puebla, Mexico.
authors: Jesús Mier
authors: JM
authors: Naylor
keywords: Horseshoe kidney; Kidney abnormalities; Kidney surgery; Renal transplantation