Laparoscopic transplant nephrectomy for failed renal allograft

• Autor(a) principal: Medeiros, Paulo
• Data de Publicação: 2018
• Outros Autores: Silva, Rodolfo A., Silva Junior, Mauricio F, Dantas Junior, José Hipolito, Paiva, Rodrigo Trigueiro Morais de, Britto, Cesar Araujo
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UFRN
• Texto Completo: https://repositorio.ufrn.br/handle/123456789/52736
• topic: donor allograft; laparoscopic; nephrectomy

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.