CASE REPORT article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1553478
This article is part of the Research Topic25 Years of 21st Century MedicineView all 10 articles
Case report: Successful transplantation of a living donor kidney with five renal arteries procured via laparoscopy and back-table vascular reconstruction using the recipient's internal iliac artery
Provisionally accepted- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Background: Laparoscopic living donor nephrectomy (LLDN) is the preferred technique for living donor kidney transplantation, but multiple renal arteries pose challenges due to increased surgical complexity. While cases with up to seven renal arteries have been reported, the occurrence of kidneys with more than three renal arteries is extremely rare. This report presents a successful retroperitoneoscopic nephrectomy in a living donor with five renal arteries, a case not previously detailed in the literature.Case report: A 65-year-old female donor with five left renal arteries underwent retroperitoneoscopic LLDN. The kidney was reconstructed ex vivo using the recipient's internal iliac artery trunk and its branches. Vascular reconstruction was achieved by anastomosing the donor's renal arteries to the recipient's iliac artery branches, forming a single arterial ostium, which was then anastomosed to the recipient's external iliac artery. The recipient, a 33-year-old male, also underwent concurrent repair of a left inguinal hernia.Postoperative outcomes were excellent, with immediate graft function, no dialysis requirement, and stable renal function at 60 days post-transplant.This case demonstrates that retroperitoneoscopic LLDN for kidneys with five renal arteries is technically feasible and safe. It highlights the utility of the recipient's internal iliac artery for ex vivo reconstruction, expanding the potential for successful transplantation in complex anatomical scenarios.
Keywords: multiple renal arteries, laparoscopic living donor nephrectomy, Kidney Transplantation, Vascular reconstruction, case report
Received: 03 Jan 2025; Accepted: 03 Jul 2025.
Copyright: © 2025 Yu, Zhang, Lv, Sheng, Chen, Zhishui, Zhang and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Daqiang Zhao, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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