Successful Fenestrated Endovascular Aneurysm Repair for a Living Kidney Transplantation Donor

Abstract

Abstract We describe a case of successful fenestrated endovascular aneurysm repair (EVAR) for a living kidney transplantation donor. A 79-year-old male visited our hospital for the treatment of a 40-mm diameter left common iliac artery aneurysm. He was a living kidney transplant donor to his son. Because left nephrectomy was planned using retroperitoneoscopy, EVAR was chosen to avoid dissection of the adhesions for organ retrieval. Preoperative computed tomography (CT) revealed a double renal artery in the right kidney, with the lower branch originating from the lower position of the abdominal aorta. We performed surgeon-modified fenestrated endografting to preserve the right lower accessory renal artery and maintain the right renal function after the left nephrectomy. A postoperative CT scan showed no endoleaks, and the blood flow of the right lower accessory renal artery was maintained. In our case, fenestrated EVAR is feasible for preservation of lower originated accessory renal artery, and contributes to maintaining the postoperative renal function of the donor.