Laparoscopic Approach for an Intra-Abdominal Kidney Allograft Nephrectomy After Pediatric Transplantation: A Case Report

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 comp...

Full description

Autores:
Echeverri Junca, Gabriel Jaime
Tipo de recurso:
Article of investigation
Fecha de publicación:
2012
Institución:
Universidad ICESI
Repositorio:
Repositorio ICESI
Idioma:
eng
OAI Identifier:
oai:repository.icesi.edu.co:10906/78512
Acceso en línea:
http://apps.webofknowledge.com/full_record.do?product=UA&search_mode=GeneralSearch&qid=24&SID=4BDShD6T2KTBoAZU7Ey&page=1&doc=1
http://hdl.handle.net/10906/78512
http://dx.doi.org/10.1016/j.transproceed.2012.06.053
Palabra clave:
Bladder disease
Pyelonephritis
Medical sciences
Ciencias socio biomédicas
Enfermedad de la vejiga
Pielonefritis
Rights
License
https://creativecommons.org/licenses/by-nc-nd/4.0/
Description
Summary: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 pneumoperitoneum, 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.