Successful Use of the Dilated Right Spermatic Cord Vein for Renal Transplantation in a Patient with Congenital Hypoplasia of the Inferior Vena Cava

Abstract

A 29-year-old man was admitted to our department with renal failure secondary to glomerulonephritis. No history of deep venous thromboses was reported, and no iliac vessel abnormality was evident on routine ultrasound (B-mode) examination before the operation. Transplantation of his mother's left kidney revealed occlusion of his common iliac vein and distal inferior vena cava (IVC). The right spermatic cord vein was noted to be dilated and suitable for venous drainage of the allograft, which was accomplished by an end-to-side anastomosis between the renal vein and the right spermatic cord vein. The allograft showed immediate function; serum creatinine was decreased to a normal value at 5 days after surgery. After the operation, a vascular spiral computerized tomographic 3-dimensional reconstruction showed absence of the infrarenal IVC with the right spermatic cord vein draining into the end of IVC. Physical examination revealed a right-side varicocele with dilated epigastric vein. The donor kidney slower normal values upon routine follow-up at 2 years after the operation.