Benjamens Stan, van den Berg Tamar Alice Johanne, Lange Johan Frédéric Michel, Pol Robert Alexander
Surgery, Universitair Medisch Centrum Groningen, Groningen, Netherlands
Medical Imaging Center, Universitair Medisch Centrum Groningen, Groningen, Netherlands.
BMJ Case Rep. 2020 Jan 22;13(1):e233523. doi: 10.1136/bcr-2019-233523.
A 70-year-old healthy male individual offered to undergo a living donor hand-assisted laparoscopic nephrectomy to enable kidney transplantation for a close relative. As required for all living transplant donor candidates, extensive screening was performed to exclude potential contraindications for donation. Tests revealed a situs inversus totalis, meaning a complete transposition of the thoracic and abdominal organs in the sagittal plane. As other contraindications for living kidney donation were absent, the feasibility of this procedure was determined multidisciplinary. A successful donation procedure was performed without surgical complications for the donor and good short-term transplant outcomes. In line with current developments that have resulted in more liberal criteria for potential living kidney donors, major anatomical deviations should not automatically be a contraindication. With multidisciplinary efforts and thorough surgical preparation at a high-volume transplant centre, this procedure is feasible and safe.
一名70岁的健康男性主动提出接受活体供者手辅助腹腔镜肾切除术，以便为一名近亲进行肾脏移植。按照所有活体移植供者候选人的要求，进行了全面筛查以排除潜在的捐献禁忌证。检查发现该患者为完全性内脏反位，即胸腔和腹腔器官在矢状面完全转位。由于不存在其他活体肾捐献的禁忌证，因此通过多学科评估确定了该手术的可行性。供者的捐献手术成功进行，无手术并发症，且移植短期效果良好。鉴于目前对潜在活体肾供者的标准更为宽松，主要解剖结构异常不应自动成为禁忌证。通过多学科努力以及在大型移植中心进行充分的手术准备，该手术是可行且安全的。
