Korean J Transplant.  2022 Nov;36(Supple 1):S85. 10.4285/ATW2022.F-2015.

Right kidney living donor transplantation with lesser asymmetric split renal function: two case reports

• Jung HS
• Yoo YS
• Kim HS
• Lee HK
• Choi SJN

• KMID: 2535601
• DOI: http://doi.org/10.4285/ATW2022.F-2015

Abstract

The number of end-stage renal disease (ESRD) patients continues to grow in South Korea. Because of the discrepancy between increase in ESRD patients and kidney donations, transplantation with expanded criteria donors is gradually being implemented. We present two cases of renal transplantation with lesser asymmetric split renal function that did not fall under the expanded criteria, but were performed as an opportunity to expand the indications for kidney donation. For case 1, a 67-year-old female un-derwent ABO-identical living related kidney transplantation from her 42-year-old son on May 2022. For case 2, a 42-year-old male underwent ABO-compatible living unrelated kidney transplantation from his 40-year-old wife on February 2022. In preoperative 99mTc-DTPA renal scan for donor evaluation, the results showed asymmetric split renal function. Scaled glomerular filtration rate of donors were 96.91 mL/min/1.73 m ² in case 1 and 165.81 mL/min/1.73 m ² in case 2. The left to right ratios of donor kidney split renal function were 62:38 in case 1 and 60:40 in case 2. Laparoscopic right donor nephrectomy was performed for the safe-ty of donor. For renal vein elongation, we obtained right gonadal vein for case 1 and right ovarian vein for case 2. The vein grafts were reconstructed as circular wide tubes for right renal vein lengthening. Elongated right renal veins were anastomosed to each of the recipients right external iliac vein with end-to-side fashion. Then we performed end-to-side anastomosis of the allograft right renal artery to each of the recipients right external iliac artery. For case 1, recipient underwent hemodialysis for 45 days due to delayed graft function. Three months after transplantation, allograft function of both recipients was acceptable. Short term outcome of our cases shows lesser asymmetric split renal function may be additional option of the expanded criteria of living donor kidney transplantation.