Kidney Transplantation in Sickle Cell Disease Patients: Case Series and Experience from a Nigerian Kidney Transplant Center.

Sickle cell nephropathy is one of the long-term complications of sickle cell disease (SCD). About a quarter of SCD patients who survive up to 40 years of age will require some form of renal replacement therapy in their lifetime. Organ transplantation in SCD patients poses great challenges, particularly in lower middle income countries (LMIC) like Nigeria. This report highlights the management of three SCD patients who successfully underwent renal transplantation. The patients were aged 39, 47, and 58 years, respectively, with similarly previous history of multiple blood transfusions, recurrent vaso-occlusive crises, and had all progressed to end-stage renal disease. Preoperative exchange blood transfusion and plasmapheresis were offered in one and two of the patients, respectively. One of them required preoperative vaccination against encapsulated organisms due to autosplenectomy. Antithymocyte globulin was used as induction therapy in two of these patients while basiliximab was used in the third. All patients are alive with good renal function 18, 24, and 48 months post transplantation, respectively. In conclusion, kidney transplantation can be safely carried out on SCD patients with a satisfactory outcome.

Congenital bilateral iliac vein anomalies in a Nigerian pediatric kidney transplant recipient: A case report and literature review.

The finding of bilateral congenital common iliac vein anomalies is indeed uncommon. This article presents the case of an 11-year-old boy with end-stage renal disease who had kidney transplantation (KT). At presentation, he was found to have a large superficial vein running from the left groin over the suprapubic area. The arterial pulsation of both lower limbs was preserved, and there was no pedal edema. Contrast-enhanced computed tomography scan revealed aplasia of the right common iliac vein, stenosis of the left common iliac vein, and marked dilatation of the left external and internal iliac veins. There were also varicosity of numerous pelvic veins and a collateral vein draining the right lower limb. This preoperative diagnosis was key to planning for surgery. On KT surgery, the renal allograft vein was anastomosed in an end-to-side fashion to the inferior vena cava and artery to the common iliac artery. The patient had a smooth postoperative recovery and continues to enjoy a normal renal function.

Résumé La découverte d'anomalies bilatérales congénitales de la veine iliaque commune est en effet rare. Cet article présente le cas d'un garçon de 11 ans avec insuffisance rénale terminale ayant subi une transplantation rénale (KT). Lors de la présentation, il a été découvert qu'il avait une grosse veine superficielle s'écoulant de l'aine gauche sur la zone sous-pubienne. La pulsation artérielle des deux membres inférieurs a été préservée et il n'y avait pas d'œdème pédale. La tomodensitométrie avec du contrast a révélé une aplasie de la veine iliaque commune droite, une sténose de la veine iliaque commune gauche et une dilatation marquée des veines iliaques externes et internes gauches. Il y avait aussi une varicosité de nombreuses veines pelviennes et une veine collatérale drainant la membre inférieure droite. Ce diagnostic préopératoire était essentiel à la planification de la chirurgie. Lors de la chirurgie KT, la veine d'allogreffe rénale a été anastomosée dans un mode à la veine cave inférieure et artère à l'artère iliaque commune. Le patient a eu une récupération postopératoire en douceur et continue de profiter d'une fonction rénale normale. Mots clés: Aplasie de la veine iliaque, Congénitale, Greffe de rein, Nigéria, Pédiatrique.