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1.
Ren Fail ; 46(1): 2300736, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38213228

RESUMO

The assessment of kidney function within the first year following transplantation is crucial for predicting long-term graft survival. This study aimed to develop a robust and accurate model using metabolite profiles to predict early long-term outcomes in patient groups at the highest risk of early graft loss. A group of 61 kidney transplant recipients underwent thorough monitoring during a one-year follow-up period, which included a one-week hospital stay and follow-up assessments at three and six months. Based on their 12-month follow-up serum creatinine levels: Group 2 had levels exceeding 1.5 mg/dl, while Group 1 had levels below 1.5 mg/dl. Metabolites were detected by mass spectrometer and first pre-processed. Univariate and multivariate statistical analyses were employed to identify significant differences between the two groups. Nineteen metabolites were found to differ significantly in the 1st week, and seventeen metabolites in the 3rd month (adjusted p-value < 0.05, quality control (QC) < 30, a fold change (FC) > 1.1 or a FC < 0.91, Variable Influence on Projection (VIP) > 1). However, no significant differences were observed in the 6th month. These distinctive metabolites mainly belonged to lipid, fatty acid, and amino acid categories. Ten models were constructed using a backward conditional approach, with the best performance seen in model 5 for Group 2 at the 1st-week mark (AUC 0.900) and model 3 at the 3rd-month mark (AUC 0.924). In conclusion, the models developed in the early stages may offer potential benefits in the management of kidney transplant patients.


Assuntos
Transplante de Rim , Humanos , Metabolômica , Análise Multivariada , Sobrevivência de Enxerto , Rejeição de Enxerto
2.
Cureus ; 14(1): e20913, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35154914

RESUMO

INTRODUCTION: Elderly patients have increased morbidity and mortality compared to younger patients due to existing comorbid diseases and chronic immunosuppression. Therefore, the option of kidney transplantation for renal replacement therapy in elderly patients is still being controversial. Our aim in this study was to evaluate graft function, graft and patient survival, and associated factors in kidney transplant recipients over 65 years of age, at 11 years of follow-up. METHODS: The study included 53 patients aged 65-76 years, out of a total of 1319 patients who underwent live kidney transplantation in the Organ Transplant Center of Acibadem International Hospital between October 2010 and July 2021. Demographic characteristics and creatinine values were recorded. Graft survival rates and patient survival rates at one, three, and five years were analyzed. RESULTS: Fifty-three patients, 14 female, 39 male, aged 65-76 years were included in the study. The follow-up period of the patients was 7-125 months. During the follow-up, 20 patients died. Graft loss occurred in two of 20 patients who died, and 18 patients died with working grafts. Graft loss developed in two of the 33 surviving patients. In the whole group, one-, three-, and five-year patient survival rates were 94%, 81%, and 76%, respectively. CONCLUSION: These results emphasize that kidney transplantation is a viable treatment option in elderly patients who have been well evaluated before kidney transplantation.

3.
Eur Surg Res ; 63(1): 46-54, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35100577

RESUMO

OBJECTIVES: The objective of this study was to compare the long-term graft outcomes of left-versus-right donor nephrectomy with multiple renal arteries (MRAs), and therefore creating a reference for the expansion of the potential living kidney donor pool. METHODS: Laparoscopic live donor nephrectomy cases between May 2010 and October 2020 were included in this retrospective cross-sectional study. The data relating to donor and recipient demographics, surgical and anatomical characteristics, recipient, and graft status were retrieved and compared using nonparametric statistical methods and multivariate regression. Analyses were fit for survival factors. RESULTS: A total of 1,009 recipients were included in this retrospective cross-sectional study with their donors. 16.7% of the donors had been discovered to have more than one renal artery supplying the donated kidney. The acute rejection rate was 12.8%. Death-censored graft survival at postoperative year 5 for single renal artery (SRA) transplants was 89.6%, 89.5% for left-sided MRAs, and 88.2% for right-sided ones. CONCLUSIONS: Both right donor nephrectomy and left donor nephrectomy are safe procedures with no significant negatively impacted rates for neither survival nor complications of the recipients in the long-term, compared to SRA ones.


Assuntos
Laparoscopia , Doadores Vivos , Estudos Transversais , Sobrevivência de Enxerto , Humanos , Rim/irrigação sanguínea , Nefrectomia/métodos , Artéria Renal/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
4.
Int J Clin Pract ; 75(9): e14465, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34107128

RESUMO

BACKGROUND: Posttransplant dyslipidemia is a common condition in renal transplantation recipients (RTR) and is related to poor cardiac outcomes. We aimed to demonstrate the value of non-high-density lipoprotein cholesterol (non-HDL-C) in predicting long-term major cardiovascular and cerebrovascular events (MACCE) in RTR with dyslipidemia. METHODS: Patients who had undergone renal transplantation between 2011 and 2019 were retrospectively analysed and were classified as normal non-HDL-C and high non-HDL-C groups based on first year levels. Development of high non-HDL-C levels was used to predict the occurrence of MACCE (a combination of cardiac death, nonfatal myocardial infarction, unstable angina, and nonfatal stroke) and all-cause death during the long-term follow-up. RESULTS: Overall, 674 patients were included, of whom 470 (69.7%) were male; the mean age was 43.6 ± 13.2 years. The mean follow-up duration was 5.5 ± 2.29 years 1 year after the transplant. MACCE occurred during the follow-up in 102 (61.8%) patients in the high non-HDL-C group and 13 (2.6%) patients in the normal non-HDL-C group (P < .001). High non-HDL-C was a predictor of MACCE in the multivariate analysis (hazard ratio [HR] 1.02, 95% confidence interval [CI] 1.01-1.02, P < .001). Smoking (HR: 1.92, 95% CI 1.16-3.20, P < .001), cadaver graft (HR: 2.55, 95% CI 1.52-4.26, P < .001), and left ventricular ejection fraction (HR: 0.96, 95% CI 0.94-0.98, P < .001) were also predictors of MACCE. Kaplan-Meier analysis revealed that all MACCE components and all-cause mortality were significantly higher in the high non-HDL-C group (P < .001). CONCLUSION: Non-HDL-C was closely related to long-term cardiac outcomes in RTR with dyslipidemia. Non-HDL-C should be among the primary goals in lipid-lowering treatment in post-transplant dyslipidemia.


Assuntos
Dislipidemias , Transplante de Rim , Infarto do Miocárdio , Adulto , Colesterol , HDL-Colesterol , Dislipidemias/epidemiologia , Humanos , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Volume Sistólico , Função Ventricular Esquerda
5.
J Laparoendosc Adv Surg Tech A ; 31(11): 1309-1314, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33471592

RESUMO

Background: A limited number of publications are available in the literature regarding laparoscopic living donor nephrectomy with vaginal extraction (LLDN-VE) for kidney transplantation. The aim of this study was to compare long-term recipient outcomes of standard laparoscopic living donor nephrectomy (S-LLDN) and LLDN-VE. Methods: A total of 652 patients [119 LLDN-VE (18.3%) and 533 S-LLDN (81.7%)] were included in this retrospective cross-sectional study. The data related to donor and recipient demographics, surgical and anatomical characteristics, and recipient and graft status were retrieved and compared using nonparametric statistical methods. Kaplan-Meier and Cox proportional hazards regression analyses were applied to compute survival according to the surgical technique. Results: The mean follow-up duration was 73.0 ± 25.4 months for S-LLDN and 69.8 ± 20.4 months for LLDN-VE recipients. The main determinants of long-term outcomes were the serum creatinine (SCr) levels, death-censored graft survival, and recipient survival at the end of the post-op 5th year. LLDN-VE recipients' discharge SCr was found to be statistically lower (P = .049) than S-LLDN patients. Graft survival rates censored for death were 93.8% for the S-LLDN and 93.3% for the LLDN-VE recipients. Cox regression analysis showed significance for younger donor age (P = .010) with the application of 17 parameters, indicating better graft survival outcomes for kidney recipients with younger donors. Conclusions: Compared with the standard method, the long-term results of LLDN-VE are in accordance with or could even be more advantageous than S-LLDN in certain aspects. LLDN-VE appears to be a feasible, safe, and cosmetically superior approach with no negative postoperative sexual or morbid effects on the donor.


Assuntos
Laparoscopia , Doadores Vivos , Estudos Transversais , Feminino , Humanos , Rim , Nefrectomia/efeitos adversos , Estudos Retrospectivos
7.
Nephron ; 142(1): 26-33, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30739116

RESUMO

BACKGROUND: Fabry disease (FD) is an X-linked lysosomal storage disorder resulting from lack of alpha-galactosidase A (AGALA) activity in lysosomes. OBJECTIVE: In this multicenter study, we aimed to evaluate the prevalence of FD in renal transplant (Tx) recipients in Turkey. We also screened dialysis patients as a control group. METHODS: All Tx and dialysis patients were screened regardless of the presence of a primary disease. We measured the AGALA activity in all male patients as initial analysis. Mutation analysis was performed in male patients with decreased AGALA activity and in female patients as the initial diagnostic assay. RESULTS: We screened 5,657 patients. A total of 17 mutations were identified. No significant difference was observed between the groups regarding the prevalence of patients with mutation. We found FD even in patients with presumed primary kidney diseases. Seventy-one relatives were analyzed and mutation was detected in 43 of them. We detected a patient with a new, unknown mutation (p.Cys223) in the GLA gene. CONCLUSIONS: There are important implications of the screening. First, detection of the undiagnosed patients leads to starting appropriate therapies for these patients. Second, the transmission of the disease to future generations may be prevented by prenatal screening after appropriate genetic counseling. In conclusion, we suggest screening of kidney Tx candidates for FD, regardless of etiologies of chronic kidney disease.


Assuntos
Doença de Fabry/epidemiologia , Terapia de Substituição Renal , Adulto , Estudos de Casos e Controles , Doença de Fabry/genética , Doença de Fabry/terapia , Feminino , Testes Genéticos , Humanos , Transplante de Rim , Masculino , Pessoa de Meia-Idade , Mutação , Turquia/epidemiologia , alfa-Galactosidase/genética
8.
J Int Med Res ; 44(6): 1376-1380, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27789806

RESUMO

Objective We planned a cross-sectional analysis to determine the frequency and severity of metabolic acidosis in patients taking topiramate while awaiting craniotomy. Methods Eighty patients (18 - 65 years) taking topiramate to control seizures while awaiting elective craniotomy were enrolled. Any signs of metabolic acidosis or topiramate-related side effects were investigated. Blood chemistry levels and arterial blood gases, including lactate, were obtained. The severity of metabolic acidosis was defined according to base excess levels as mild or moderate. Results Blood gas analysis showed that 71% ( n = 57) of patients had metabolic acidosis. The frequency of moderate metabolic acidosis was 56% ( n = 45), while that of mild metabolic acidosis was 15% ( n = 12). A high respiratory rate was reported in only 10% of moderately acidotic patients. Conclusions In patients receiving topiramate, baseline blood gas analysis should be performed preoperatively to determine the presence and severity of metabolic acidosis.


Assuntos
Acidose/diagnóstico , Anticonvulsivantes/efeitos adversos , Frutose/análogos & derivados , Convulsões/tratamento farmacológico , Acidose/sangue , Adolescente , Adulto , Idoso , Anticonvulsivantes/administração & dosagem , Gasometria , Estudos Transversais , Feminino , Frutose/administração & dosagem , Frutose/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Taxa Respiratória/efeitos dos fármacos , Taxa Respiratória/fisiologia , Convulsões/fisiopatologia , Índice de Gravidade de Doença , Topiramato
9.
Ann Transplant ; 20: 634-8, 2015 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-26489713

RESUMO

BACKGROUND: Laparoscopic approach has become the standard procedure for living donor nephrectomy in many transplant centers. Because the conventional approach results in cosmetic problems and pain during laparoscopic live donor nephrectomy, transvaginal extraction of an intact kidney has been recently introduced as a minimally invasive technique. Here, we aimed to investigate whether transvaginal extraction of an intact kidney during laparoscopic live donor nephrectomy is associated with decreased postoperative pain, nausea and vomiting, and morphine consumption. MATERIAL AND METHODS: This prospective data analysis included a total of 27 female donors who underwent laparoscopic removal of a single kidney for living donor nephrectomy through conventional or transvaginal route. Data collected included age, body mass index, ASA scores, histocompatibility, additional medical disorders, peri- and postoperative complications, postoperative pain scores with visual analogue pain scores (VAS), length of postoperative stay, morphine consumption, degree of nausea and vomiting, level of sedation, and pruritus. RESULTS: No significant differences between the transvaginal and conventional groups were observed in VAS scores and morphine consumption at postoperative 1, 3, 6, 12, and 24 hours. Although not reaching statistical significance, according to analysis of morphine consumption, there was a trend toward decreasing analgesic requirements in the transvaginal group at postoperative 12 and 24 hours. There were no significant differences between the groups in terms of degree of nausea or vomiting, or length of postoperative hospital stay. CONCLUSIONS: We suggest that with a more desirable cosmetic result, transvaginal natural orifice transluminal endoscopic surgery-assisted living donor nephrectomy (TVNALDN) is a suitable new minimally invasive laparoscopic technique associated with reduced postoperative pain and analgesic requirements in select women.


Assuntos
Laparoscopia/métodos , Doadores Vivos , Nefrectomia/métodos , Dor Pós-Operatória/etiologia , Adulto , Feminino , Humanos , Laparoscopia/efeitos adversos , Pessoa de Meia-Idade , Nefrectomia/efeitos adversos , Estudos Prospectivos
10.
Ren Fail ; 37(8): 1293-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26399977

RESUMO

OBJECTIVE: The aim of this study was to investigate the effect of two different types of high-flux dialysis membranes on insulin resistance among patients who are receiving hemodialysis (HD) due to end-stage renal failure (ESRF). MATERIALS AND METHODS: Forty-six (21 female, 25 male) patients were included in the study, who were on HD treatment due to stage-5 chronic renal failure. Prior to the study, fasting insulin resistance via Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) and fractioned urea clearance (Kt/V) values were calculated using the urokinetic model. The polysulfone (PS) dialysis membrane of all patients included in the study was replaced with "polyarylethersulfone, polyvinylpyrrolidone, polyamide (PPP)" high-flux membrane that has the same surface area over 12 weeks. At the end of the 12-week period, HOMA and Kt/V values were recalculated. RESULTS: At the end of the 12-week period, Kt/V values rose statistically significant from 1.575 to 1.752 (p = 0.002). HOMA-IR values declined, though not statistically significant, from 3.268 to 2.926 (p = 0.085). PPP high-flux membrane increased the Kt/V values significantly compared to the PS membrane, while it decreased the insulin resistance and increased insulin sensitivity. CONCLUSION: The two different types of high-flux dialysis membranes used for HD have different effects on insulin sensitivity. Compared to the PS membrane, PPP high-flux membrane decreased insulin resistance by increasing insulin sensitivity among non-diabetic ESRF patients.


Assuntos
Glicemia/análise , Resistência à Insulina , Insulina/sangue , Falência Renal Crônica/terapia , Membranas Artificiais , Diálise Renal/classificação , Idoso , Jejum , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nylons , Excipientes Farmacêuticos , Polímeros , Povidona , Sulfonas
11.
Ann Transplant ; 20: 418-23, 2015 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-26204418

RESUMO

BACKGROUND: The most common treatment modality for postoperative pain relief following laparoscopic surgery is multimodal, using nonsteroidal antiinflammatory drugs (NSAID), opioids, and infiltration of local anesthetics. Because NSAIDs are nephrotoxic, local infiltration does not relieve deep tissue pain, and opioids have an adverse effects profile including pruritus, nausea, vomiting, oversedation, apnea, and decreased gastrointestinal motility. Therefore, the use of a regional analgesic technique can lead to an improved quality of recovery. The aim of this prospective, randomized, placebo-controlled study was to evaluate the effect of TAP block on postoperative verbal analog scale (VAS) scores and total morphine requirements in the first 24 hours after laparoscopic live donor nephrectomy. MATERIAL AND METHODS: After obtaining approval from the hospital ethics committee and written informed consent from the patients, 49 ASA I-II patients undergoing laparoscopic donor nephrectomy, aged 18 years or over, were included in this prospective, randomized, controlled study. In this clinical trial patients were divided into 2 groups: TAP block group (group T) and placebo group (group P). The demographic variables, pain scores, morphine consumption, level of sedation, presence of postoperative nausea, vomiting, pruritus, and average length of postoperative stay were reviewed. RESULTS: The pain scores were significantly lower after TAP block with bupivacaine at most but not all time points. Patients receiving the TAP block with bupivacaine required less morphine up to 24 hours after surgery compared with the saline group. CONCLUSIONS: USG-guided TAP block as part of a balanced analgesia regimen is of benefit in reducing postoperative pain and morphine consumption after laparoscopic donor nephrectomy.


Assuntos
Anestésicos Locais/uso terapêutico , Bupivacaína/uso terapêutico , Transplante de Rim/efeitos adversos , Doadores Vivos , Nefrectomia/efeitos adversos , Manejo da Dor/métodos , Dor Pós-Operatória/tratamento farmacológico , Adulto , Método Duplo-Cego , Feminino , Humanos , Transplante de Rim/métodos , Laparoscopia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Morfina/uso terapêutico , Entorpecentes/uso terapêutico , Nefrectomia/métodos , Medição da Dor , Estudos Prospectivos , Resultado do Tratamento
12.
JSLS ; 18(3)2014.
Artigo em Inglês | MEDLINE | ID: mdl-25419107

RESUMO

BACKGROUND AND OBJECTIVES: The aim of this retrospective study was to compare conventional laparoscopic living-donor nephrectomy with transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy in terms of feasibility and reproducibility. METHODS: A total of 115 consecutive female patients who underwent laparoscopic living-donor nephrectomy (n=70) or transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy (n=45) were included and compared in terms of operative characteristics, as well as donor and recipient outcomes. RESULTS: No significant difference was observed between the laparoscopic living-donor nephrectomy and transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy groups in terms of mean duration of warm and cold ischemia, operation time, length of hospital stay, arterial anastomoses, visual analog scale pain scores, serum creatinine levels, and receiver outcomes, whereas a significantly higher number of venous anastomoses was noted in the laparoscopic living-donor nephrectomy group than in the transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy group (P=.029). CONCLUSIONS: Transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy seems to be a feasible and reproducible alternative to conventional laparoscopic living-donor nephrectomy in female donors provided the viability of the vagina as an organ retrieval route.


Assuntos
Transplante de Rim , Laparoscopia/métodos , Doadores Vivos , Cirurgia Endoscópica por Orifício Natural/métodos , Nefrectomia/métodos , Coleta de Tecidos e Órgãos/métodos , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Vagina
13.
Ann Transplant ; 19: 551-5, 2014 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-25356806

RESUMO

BACKGROUND: This study presents our initial experience with laparoendoscopic single-site donor nephrectomy. Ten patients (8 females, 2 males; mean age 45.3 ± 13.2 years) underwent LESS-DN. MATERIAL/METHODS: Transumbilical laparoscopic donor nephrectomy was performed using an SILS™ port. Standard laparoscopic instruments and a 30-degree angled camera were used during the surgery. We evaluated the following parameters: warm and cold ischemia time, duration of the operation, amount of blood loss during the operation, duration of hospitalization, creatinine level, and visual analogue scale score for pain at discharge. RESULTS: The means for duration of operation, warm ischemia time, and duration of hospitalization were 140 min, 194 s, and 1.4 days, respectively. Intraoperative and/or postoperative complications were not observed. Low pain score and cosmetic advantage were remarkable. All recipients had functional grafts. The results of our initial experience with LESS-DN appeared to be positive. CONCLUSIONS: Further studies on the LESS-DN technique with larger series conducted in different centers are needed.


Assuntos
Transplante de Rim , Laparoscopia/métodos , Doadores Vivos , Nefrectomia/métodos , Adulto , Perda Sanguínea Cirúrgica , Isquemia Fria , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Dor Pós-Operatória , Isquemia Quente
14.
Int J Artif Organs ; 37(2): 118-25, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24619898

RESUMO

PURPOSE: Secondary hyperparathyroidism (SHPT) is a common feature in maintenance hemodialysis (MHD) patients. Inadequate treatment of SHPT has been associated with cardiovascular complications, and vitamin D therapy might influence the development of cardiovascular diseases. In the present study, we aimed to evaluate the effects of intravenous paricalcitol and calcitriol treatments on left ventricular mass index changes in MHD patients. METHODS: We conducted an observational study with a 12-month follow-up duration to compare the outcomes of intravenous paricalcitol and calcitriol treatments in MHD patients. Eighty patients with moderate to severe SHPT were enrolled in the study. All the patients had normalized total serum Ca concentration <10.5 mg/dL, serum calcium-phosphorus product (Ca × P) <75, and parathyroid hormone level (PTH) level ≥300 pg/mL at the begining of the follow-up period. RESULTS: The patients were divided into a paricalcitol group (n = 40) and a calcitriol group (n = 40). The demographic, clinical, and biochemical characteristics of the patients were similar at baseline. We observed significantly superior control of SHPT; lesser frequency of hypercalcemia and hyperphosphatemia, and Ca × P level elevations; and interruption of vitamin D treatment in the paricalcitol group. Moreover, we found no significant change in left ventricular mass index in the paricalcitol group, but found a significantly increased left ventricular mass index in the calcitriol group during the follow-up period (from 136.6 ± 35.2 g/m2 to 132.9 ± 40.4 g/m2 vs. from 137.2 ± 30.1 g/m2 to 149.4 ± 31.0 g/m2; p<0.044). CONCLUSION: We observed that, compared with calcitriol therapy, paricalcitol therapy reduced the PTH concentrations more effectively without causing hypercalcemia and hyperphosphatemia and might have a substantial beneficial effect on the development of left ventricular hypertrophy.


Assuntos
Calcitriol/administração & dosagem , Ergocalciferóis/administração & dosagem , Hiperparatireoidismo Secundário/tratamento farmacológico , Hipertrofia Ventricular Esquerda/prevenção & controle , Diálise Renal/efeitos adversos , Adulto , Monitoramento de Medicamentos/métodos , Feminino , Humanos , Hiperparatireoidismo Secundário/etiologia , Hiperparatireoidismo Secundário/metabolismo , Hipertrofia Ventricular Esquerda/etiologia , Hipertrofia Ventricular Esquerda/metabolismo , Masculino , Pessoa de Meia-Idade , Diálise Renal/métodos , Resultado do Tratamento , Vitamina D/análogos & derivados , Vitamina D/metabolismo , Vitaminas/administração & dosagem
15.
Exp Clin Transplant ; 11(2): 195-8, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23075054

RESUMO

Situs inversus totalis is a rare anomaly characterized by the total inversion of all abdominal and thoracic organs. For the first time, we report a case of a donor nephrectomy in a patient with situs inversus totalis, completed with a full laparoscopic approach. At the time of this writing, the donor and the recipient are doing well after 6 month's follow-up. Our experience shows that patients with situs inversus totalis may be eligible candidates for laparoscopic donor nephrectomy, provided that detailed preoperative imaging studies as well as precise preoperative planning are performed before the transplant.


Assuntos
Transplante de Rim , Laparoscopia/métodos , Nefrectomia/métodos , Situs Inversus/cirurgia , Doadores de Tecidos , Adulto , Feminino , Humanos , Falência Renal Crônica/cirurgia , Masculino , Situs Inversus/diagnóstico por imagem , Cônjuges , Tomografia Computadorizada por Raios X
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