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Case Reports in Transplantation
Volume 2011, Article ID 153493, 4 pages
http://dx.doi.org/10.1155/2011/153493
Case Report

Laparoscopic-Assisted Recipient Nephrectomy and Recipient Kidney Procurement during Orthotopic Living-Related Kidney Transplantation

1Department of Digestive Surgery and Transplantation, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium
2Department of Nephrology, Universitair Ziekenhuis Brussel, 1090 Brussel, Belgium
3Department of Urology, Hopital de la Dorcas, 7500 Tournai, Belgium
4Department of Nephrology, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium

Received 1 May 2011; Accepted 6 June 2011

Academic Editors: M. Ferraresso, Y. S. Kim, and L. Sebbag

Copyright © 2011 Dimitri Mikhalski et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Advanced atherosclerosis or thrombosis of iliac vessels can constitute an absolute contraindication for heterotopic kidney transplantation. We report the case of a 42-year-old women with end-stage renal disease due to lupus nephritis and a history of bilateral thrombosis of iliac arteries caused by antiphospholipid antibodies. Occlusion had been treated by the bilateral placement of wall stents which precluded vascular anastomosis. The patient was transplanted with a right kidney procured by laparoscopic nephrectomy from her HLA semi-identical sister. The recipient had left nephrectomy after laparoscopical transperitoneal dissection. The donor kidney was orthotopically transplanted with end-to-end anastomosis of graft vessels to native renal vessels and of the graft and native ureter. Although, the patient received full anticoagulation because of a cardiac valve and antiphospholipid antibodies, she had no postoperative complication in spite of a short period of delayed graft function. Serum creatinine levels three months after transplantation were at 1.0 mg/dl. Our case documents that orthotopical transplantation of laparoscopically procured living donor kidneys at the site of recipient nephrectomy is a feasible procedure in patients with surgical contraindication of standard heterotopic kidney transplantation.