KIDNEY TRANSPLANTATION USING SPLIT HORSESHOE KIDNEY – A CASE REPORT

Autori:

Dean Markić, Romano Oguić, Kristian Krpina, Antun Gršković, Dražen Rahelić, Nino Rubinić, Mauro Materljan, Ivan Vukelić, Sanjin Rački, Josip Španjol

Sažetak
Potkovičasti bubreg najčešća je fuzijska anomalija bubrega. Darivatelji koji imaju potkovičasti bubreg smatraju se suboptimalnima zbog čestih vaskularnih i uroloških anomalija. Prikazat ćemo transplantaciju potkovičastog bubrega mladoga kadaveričnog darivatelja. Nakon učinjene eksplantacije en bloc bubreg je uz adekvatno prepariranje krvnih žila i uretera razdvojen na dva dijela. Oba dijela potkovičastog bubrega uspješno su transplantirana u dva različita bolesnika u terminalnom stadiju kronične bubrežne insuficijencije. Poslijeoperacijski tijek bio je uredan i oba bolesnika 18 mjeseci nakon transplantacije imaju normalnu bubrežnu funkciju. Transplantacija potkovičastog bubrega zbog anatomskih je razloga zahtjevnija, ali s obzirom na to da su njezini rezultati podjednaki onima u standardnoj transplantacijskoj populaciji, trebalo bi potaknuti transplantacijske kirurge da iskoriste bubrege s ovom anomalijom.
Summary

Horseshoe kidney is the most common fusion anomaly of the kidney. Donors with horseshoe kidneys are considered suboptimal because of concomitant vascular and urologic abnormalities. We present a young cadaveric donor with a horseshoe kidney. After en-bloc explantation of the kidney, its vasculature and ureter were properly prepared and kidney was transected into two parts. Both moieties were successfully transplanted in two patients with endstage renal disease. Postoperative course was uneventful and both patients have normal kidney function 18 months after transplantation. Transplantation of horseshoe kidney is demanding due to complex anatomy but its results are equal when compared to standard transplant population. The transplant surgeon must be aware that horseshoe kidneys can safely be utilised.