Complication Arising from a Duplicated Inferior Vena Cava following Laparoscopic Living Donor Nephrectomy: A Case Report

• Published in: Transplantation proceedings Vol. 44; no. 5; pp. 1450 - 1452
• Main Authors: Christakis, P.G, Cimsit, B, Kulkarni, S
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01.06.2012; Elsevier
• Subjects: Adult; Biological and medical sciences; Digestive system. Abdomen; Endoscopy; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Investigative techniques, diagnostic techniques (general aspects); Kidney Transplantation - adverse effects; Kidney Transplantation - methods; Laparoscopy - adverse effects; Living Donors; Male; Medical sciences; Nephrectomy - adverse effects; Phlebography - methods; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Testicular Hydrocele - diagnostic imaging; Testicular Hydrocele - etiology; Testicular Hydrocele - therapy; Time Factors; Tissue, organ and graft immunology; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography; Vena Cava, Inferior - abnormalities; Vena Cava, Inferior - diagnostic imaging; Human; Endoscopic surgery; Living donor; Laparoscopy; Transplantation; Kidney; Case study; Medicine; Treatment; Urinary system; Nephrectomy; Complication; Graft; Endoscopy; Organ harvesting; Inferior vena cava
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2011.11.064

Abstract Selecting a kidney for living donor nephrectomy is driven by the tenet that donors are left with the higher functioning kidney. Traditionally, the left kidney is used because it has a longer renal vein, which aids anastamosis, and has an easier surgical approach. Anomalous left renal vasculature is not considered a contraindication to living donor nephrectomy. In the case of duplicated inferior vena cava, no specific considerations have been reported. We present a 42-year-old patient with infrarenal duplication of the vena cava who underwent laparoscopic living donor nephrectomy. His postoperative course was complicated by painful scrotal swelling necessitating multiple emergency room visits. Ultrasonography revealed bilateral hydroceles 5 weeks after surgery, which resolved with the use of a scrotal sling. Intraoperative ligation of a visibly dilated left gonadal vein was the likely etiology. Careful consideration should be taken in living donor nephrectomy in patients with duplication of inferior vena cava.