Laparoscopic Transplant Nephrectomy for Failed Renal Allograft

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Abstract

Traditionally, transplant nephrectomy for a failed renal allograft is performed using open surgery. This approach is associated with bleeding during surgery or infected hematoma, postoperatively.

Minimally invasive surgery for removal of a failed renal allograft has previously been reported using robotic technique. These procedures are challenging due to the substantial fibrosis that forms around a retroperitoneal allograft.

We report our experience with two cases, using laparoscopic approach.

A 47-year-old female lost function of his deceased donor allograft after 1,5 year due rejection and infection, presented with fever, pain in renal fossa and hematuria. The operation was performed intra-abdominally using the laparoscopic with four trocars. The total operative time was 300 min and the estimated blood loss was 250 cm.

A 46 year old female patient lost function of his deceased donor allograft after 2 year due atypical hemolytic uremic syndrome. The operative time was 340 min, intraoperative blood loss -150 ml.

There were no peri-operative complications observed and the patients were discharged to home in 4 days postoperatively.

This method is technically demanding and surgeon needs considerable laparoscopic experience to try this approach.

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