Anatomic Diversity Encountered During Laparoscopic Hand-Assisted Transperitoneal Donor Nephrectomy: A Case Report of Complete Caval Duplication.
BACKGROUND
Laparoscopic donor nephrectomy is widely used to retrieve a kidney for transplantation. Preoperative evaluation of the donor is of crucial importance to the recipient. In particular, vascular anatomy should be assessed with the help of modern imaging modalities. We present a hand-assisted laparoscopic nephrectomy of a kidney donor with a complete duplex vena cava.


METHODS
A 40-year-old male patient was admitted to our clinic as a kidney donor for his 20-year-old son. After the preliminary tests, further imaging with the use of computerized tomographic angiography showed a complete duplex vena cava. He had no morbidities or previous surgeries. A hand-assisted transperitoneal laparoscopic left nephrectomy was performed as the kidney removal technique commonly used in our center. There was minimal blood loss, and the warm ischemia time was 66 minutes. Operation time was 265 minutes. After transplantation had been performed, graft functions were good with normal urine output. Blood sample tests were in normal ranges. The live donor was discharged on the 7th day after the procedure without any complications.


CONCLUSIONS
Although renal vascular anomalies are rarely seen, they have a significant impact on the outcomes of the renal transplantation. Knowing the vascular anatomy minimizes the complications risk and increases the success rate. Laparoscopic live-donor nephrectomy can be performed safely, even in patients with vascular anomalies.
Organ Transplantation and Urology Clinic, Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey.
S L
SL
Kirecci
Pediatric Surgery and Organ Transplantation Clinic, Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey.
M
M
Demir
Organ Transplantation and Urology Clinic, Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey. Electronic address: ilgimusab@gmail.com.
M
M
Ilgi
General Surgery Clinic, Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey.
M
M
Battal
Pediatric Surgery and Organ Transplantation Clinic, Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey.
A I
AI
Dokucu
Nephrology Clinic, Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey.
A
A
Unsal
D000328:Adult; D058733:Hand-Assisted Laparoscopy / Q000379:methods*; D006801:Humans; D007668:Kidney / Q000098:blood supply; D016030:Kidney Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D020858:Tissue and Organ Harvesting; D060053:Transplant Donor Site; D014682:Vena Cava, Inferior / Q000002:abnormalities*; D052096:Warm Ischemia