Repair with Gonadal Vein Patch in the Unexpected Left Renal Vein Injury During Donor Nephrectomy

Abstract

Objective: The objective of this presentation is to share our experiences with an unusual repair of a defective graft renal vein using an own gonadal vein, which occurred iatrogenically during a laparoscopic donor nephrectomy. Case Report: A 35-year-old man with situs inversus totalis was referred to our clinic for a living-related renal transplant with a diagnosis of end-stage renal disease. The donor was 66-year-old mother of the patient. Laparoscopic left donor nephrectomy was planned for his mother . At the end of laparascopic disection renal vein tear occurred during the renal extraction. Without any intervention renal extraction was performed to maintain the patency of renal allograft and to stabilize the donor. Partial hemorrhage from renal vein was brought under control. Donor nephrectomy was completed with a defective remaining segment of renal vein. We decided to repair with gonadal vein patch ın the unexpected renal vein injury. Patch from tearing part of renal vein with short gonadal vein repairment was performed. After repairment of graft renal vein, anastomosis to external iliac vein was performed. The trans-plant procedure was completed successfully. The kidney functioned immediately. Doppler ultrasound revealed that perfusion of the kidney was normal. The postoperative creatinine levels of recipient were in the normal ranges. Daily urine output was normal. Conclusion: Repairment of a defective graft renal vein by using own gonadal vein seems to be a simple, safe, and reliable method. This technique provides an alternative approach for the reconstruction of vessels in living-donor kidney transplants.