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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