Anatomic Diversity Encountered During Laparoscopic Hand-Assisted Transperitoneal Donor Nephrectomy: A Case Report of Complete Caval Duplication

Introduction

Laparoscopic donor nephrectomy is widely used to retrieve a kidney for transplantation. Preoperative evaluation of the donor is of crucial importance to the recipient. In particular, vascular anatomy should be assessed with the help of modern imaging modalities. We present a hand-assisted laparoscopic nephrectomy of a kidney donor with a complete duplex vena cava.

Case Report

A 40-year-old male patient was admitted to our clinic as a kidney donor for his 20-year-old son. After the preliminary tests, further imaging with the use of computerized tomographic angiography showed a complete duplex vena cava. He had no morbidities or previous surgeries. A hand-assisted transperitoneal laparoscopic left nephrectomy was performed as the kidney removal technique commonly used in our center. There was minimal blood loss, and the warm ischemia time was 66 minutes. Operation time was 265 minutes. After transplantation had been performed, graft functions were good with normal urine output. Blood sample tests were in normal ranges. The live donor was discharged on the 7th day after the procedure without any complications.

Conclusions

Although renal vascular anomalies are rarely seen, they have a significant impact on the outcomes of the renal transplantation. Knowing the vascular anatomy minimizes the complications risk and increases the success rate. Laparoscopic live-donor nephrectomy can be performed safely, even in patients with vascular anomalies.