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Simultaneous laparoscopic left lateral sectionectomy and nephrectomy in the same living donor: The first case report

S. V. GautierDepartment of Surgery, National Medical Research Center of Transplantology and Artificial Organs named after academician V.I. Shumakov, Moscow, RussiaA. R. MonakhovDepartment of Surgery, National Medical Research Center of Transplantology and Artificial Organs named after academician V.I. Shumakov, Moscow, RussiaИ. А. МилосердовDepartment of Surgery, National Medical Research Center of Transplantology and Artificial Organs named after academician V.I. Shumakov, Moscow, RussiaSergey ArzumanovOlga TsirulnikovaDepartment of Transplantology and Artificial Organs, Sechenov First Moscow State Medical University, Moscow, RussiaKonstantin SemashDepartment of Surgery, National Medical Research Center of Transplantology and Artificial Organs named after academician V.I. Shumakov, Moscow, RussiaTimur DzhanbekovDepartment of Surgery, National Medical Research Center of Transplantology and Artificial Organs named after academician V.I. Shumakov, Moscow, Russia
2019en
ABI

Аннотация

With the presence of organ shortage, living donors remain important sources of grafts, especially for pediatric recipients. Laparoscopic nephrectomy has become the gold standard for living donors. Additionally, laparoscopic partial liver procurement in living donors has proven its safety and feasibility in the latest studies. We have combined both approaches to perform a simultaneous liver-kidney transplantation in a pediatric patient from the same living donor. Our experience of laparoscopic left lateral sectionectomy and laparoscopic nephrectomy in living donors was the basis for adapting to this procedure. A 29-year-old mother was an ABO-incompatible (ABOi) donor for the left lateral section (LLS) of the liver and left kidney for her 2-year-old son. The postoperative period was uneventful. Two sessions of plasmapheresis and rituximab induction were necessary to prepare for ABOi transplantation. The donor and recipient were discharged on postoperative days 5 and 28, respectively. Simultaneous laparoscopic left lateral sectionectomy and nephrectomy in the same living donor is feasible for transplantation from the parent to the child with advanced laparoscopic expertise. With the presence of organ shortage, living donors remain important sources of grafts, especially for pediatric recipients. Laparoscopic nephrectomy has become the gold standard for living donors. Additionally, laparoscopic partial liver procurement in living donors has proven its safety and feasibility in the latest studies. We have combined both approaches to perform a simultaneous liver-kidney transplantation in a pediatric patient from the same living donor. Our experience of laparoscopic left lateral sectionectomy and laparoscopic nephrectomy in living donors was the basis for adapting to this procedure. A 29-year-old mother was an ABO-incompatible (ABOi) donor for the left lateral section (LLS) of the liver and left kidney for her 2-year-old son. The postoperative period was uneventful. Two sessions of plasmapheresis and rituximab induction were necessary to prepare for ABOi transplantation. The donor and recipient were discharged on postoperative days 5 and 28, respectively. Simultaneous laparoscopic left lateral sectionectomy and nephrectomy in the same living donor is feasible for transplantation from the parent to the child with advanced laparoscopic expertise.

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