Specificities of transplantation of kidneys procured from donors with situs inversus totalis – A case report and review of the literature

Milica Petrovic; Violeta Rabrenović; Dušica Stamenković; Neven Vavić; Zoran Kovačević; Ljiljana Ignjatović; Dragan Jovanović; Svetlana Antić; Novak Milović; Aleksandrar Tomić; Vladimir Bančević

doi:10.2298/4632

Milica Petrovic Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia;
Violeta Rabrenović Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Dušica Stamenković Clinic of Anaesthesia and Intensive Care Military Medical Academy, Belgrade, Serbia
Neven Vavić Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
Zoran Kovačević Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Ljiljana Ignjatović Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
Dragan Jovanović Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Svetlana Antić Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia
Novak Milović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic of Urology Military Medical Academy, Belgrade, Serbia
Aleksandrar Tomić Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic of Vascular and Endovascular Surgery, Military Medical Academy, Belgrade, Serbia
Vladimir Bančević Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic of Urology Military Medical Academy, Belgrade, Serbia

DOI: https://doi.org/10.2298/4632

Keywords: situs inversus, kidney transplantation, tissue donors,

Abstract

Introduction. Situs inversus totalis (SIT) represents a total vertical transposition of the thoracic and abdominal organs which are arranged in a mirror image reversal of the normal positioning ¹. We presented a successful pre-dialysis kidney transplantation from a living sibling donor with SIT and the longest donor follow-up period, along with analysis of the reviewed literature. Case report. The pair for pre-dialysis kidney transplantation included a 68-year-old mother and 34-year-old daughter at low immunological risk. Comorbidities evidenced in kidney donors with previously diagnosed SIT, included moderate arterial hypertension and borderline blood glucose level. Explantation of the left donor kidney and its placement into the right iliac fossa of the recipient were performed in the course of the surgical procedure. A month after nephrectomy, second degree renal failure was noticed in the donor. A 20-month follow-up of the donor’s kidney and graft in the recipient proved that their functions were excellent. Conclusion. In donors with previously diagnosed SIT the multidisciplinary approach, preoperative evaluation of the patient and detection of possible vascular anomalies are required to provide maximum safety for the donor.

Author Biography

Milica Petrovic, Clinic of Nephrology, Military Medical Academy, Belgrade, Serbia;

Department of nephrology

Nephrologist

References

Sharma S, Chaitanya KK, Suseelamma D. Situs Inversus Totalis (Dextroversion) - An Anatomical Study. Anat Physiol 2012; 2(5): 112.

Borgaonkar VD, Deshpande SS, Kulkarni VV. Laparoscopic cho-lecystectomy and appendicectomy in situs inversus totalis: A case report and review of literature. J Minim Access Surg 2011; 7(4): 242−5.

Khandelwal RG, Karthikeayan S, Balachandar TG, Reddy PK. Lapa-roscopic Nissen fundoplication in situs inversus totalis: Tech-nical and ergonomic issues. J Minim Access Surg 2010; 6(4): 116−8.

Akbulut S, Caliskan A, Ekin A, Yagmur Y. Left-sided acute ap-pendicitis with situs inversus totalis: review of 63 published cases and report of two cases. J Gastrointest Surg 2010; 14(9): 1422−8.

Kulesza RJ, Kalmey KJ, Dudas B, Buck RW. Vascular anomalies in a case of situs inversus. Folia Morphol 2007; 66(1): 69−73.

Ruben GD, Templeton JM, Ziegler MM. Situs inversus: The com-plex inducing neonatal intestinal obstruction. J Pediatr Surg 1983; 18(6): 751−6.

Shenoy VG, Jawale SA, Oak SN, Kulkarni BK. Esophageal atre-sia with distal tracheoesophageal fistula associated with situs inversus. Pediatr Surg Int 2001; 17(7): 538−9.

Polak WG, Chudoba PJ, Patrzalek D, Szyber P. Organ donor with complete situs inversus. Case report and review of the litera-ture. Ann Transplant 2006; 11(1): 43−6.

Blegen HM. Surgery in Situs Inversus. Ann Surg 1949; 129(2): 244−59.

Fonkalsrud EW, Tompkins R, Clatworthy HW. Abdominal ma-nifestations of situs inversus in infants and children. Arch Surg 1966; 92(5): 791−5.

Hoffman MA, Celli S, Ninkov P, Rolles K, Calne RY. Orthotopic transplantation of the liver in children with biliary atresia and polysplenia syndrome: report of two cases. J Pediatr Surg 1989; 24(10): 1020−2.

Farmer DG, Shaked A, Olthoff KM, Imagawa DK, Millis JM, Busut-til RW. Evaluation, operative management, and outcome after liver transplantation in children with biliary atresia and situs inversus. Ann Surg 1995; 222(1): 47−50.

Berdat PA, Mohacsi P, Althaus U, Carrel T. Successful heart transplantation in a patient with Ivemark syndrome combined with situs inversus, single atrium and ventricle after total cavo-pulmonary connection. Eur J Cardiothorac Surg 1998; 14(6): 631−4.

Graeter T, Schäfers HJ, Wahlers T, Borst HG. Lung transplanta-tion in Kartagener's syndrome. J Heart Lung Transplant 1994; 13(4): 724−6.

Pavlidis TE, Psarras K, Triantafyllou A, Marakis GN, Sakantamis AK. Laparoscopic cholecystectomy for severe acute cholecysti-tis in a patient with situs inversus totalis and posterior cystic artery. Diagn Ther Endosc 2008; 2008: 465272.

Fernandes MN, Neiva IN, de Assis C, Meguins F, Fernandes LC, Meguins MN. Three-Port Laparoscopic Cholecystectomy in a Brazilian Amazon Woman with Situs Inversus Totalis: Surgical Approach. Case Rep Gastroenterol 2008; 2(2): 170−4.

Iusco DR, Sacco S, Ismail I, Bonomi S, Virzì S. Three-trocar lapa-roscopic cholecystectomy in patient with situs viscerum inver-sus totalis: case report and review of the literature. G Chir 2012; 33(1−2): 10−3.

Salama IA, Abdullah MH, Houseni M. Laparoscopic cholecys-tectomy in situs inversus totalis: Feasibility and review of lite-rature. Int J Surg Case Rep 2013; 4(8): 711−5.

Seo KW, Yoon YK. Laparoscopy-assisted distal gastrectomy for early gastric cancer and laparoscopic cholecystectomy for gall-stone with situs inversus totalis: a case report. J Korean Surg Soc 2011; 81(Suppl 1): 34−8.

Futawatari N, Kikuchi S, Moriya H, Katada N, Sakuramoto S, Wa-tanabe M. Laparoscopy-assisted distal gastrectomy for early gastric cancer with complete situs inversus: report of a case. Surg Today 2010; 40(1): 64−7.

Hiratsuka T, Ohta M, Sonoda K, Yamamura S, Nishizaki T, Matsu-saka T, et al. Simultaneous operation of laparoscopy-assisted distal gastrectomy with laparoscopic cholecystectomy. Hepa-togastroenterology 2007; 54(78): 1645−7.

Uemura S, Maeda H, Munekage M, Yoshioka R, Okabayashi T, Hanazaki K. Hepatic resection for metastatic colon cancer in patients with situs inversus totalis complicated by multiple anomalies of the hepatobiliary system: the first case report. J Gastrointest Surg 2009; 13(9): 1724−7.

Yodonawa S, Goto Y, Ogawa I, Yoshida S, Itoh H, Nozaki R, et al. Laparoscopic splenectomy for idiopathic thrombocytopenic purpura in a woman with situs inversus: Report of a Case. Surg Today 2010; 40(12): 1176−8.

Murakawa T, Nakajima J, Fukami T, Kusakabe M, Shibahara J, Goto A, Takamoto S. Lung cancer operation in situs inversus totalis patient. Kyobu Geka 2009; 62(11): 1010−3.

Raynor SC, Wood RP, Spanta AD, Shaw BW. Liver transplanta-tion in a patient with abdominal situs inversus. Transplantation 1988; 45(3): 661−3.

Wei JM, Liu Y, Qiao J, Wu W. Liver transplantation in a patient with situs inversus: a case report. Chin Med J (Engl) 2007; 120(15): 1376−7.

Doty DB, Renlund DG, Caputo GR, Burton NA, Jones KW. Cardiac transplantation in situs inversus. J Thorac Cardiovasc Surg 1990; 99(3): 493−9.

Rábago G, Copeland JG, Rosapepe F, Tsen AC, Arzouman DA, Arabia FA, Sethi GK. Heart-lung transplantation in situs inver-sus. Ann Thorac Surg 1996; 62(1): 296−8.

Black PC, Porter JR, Charpentier KP, Bakthavatsalam R, Marsh CL. Hand-assisted laparoscopic right-donor nephrectomy in a pa-tient with situs inversus. Transplantation 2003; 76(10): 1530.

Hoffmann D, Gunselman J, Chewaproug D, Kung SC, Khanmoradi K, Zaki R, et al.. Living-related Donor Nephrectomy in a Patient With Complete Situs Inversus. J Exp Clin Med 2010; 2(6): 305−6.

Berber I, Gures N, Gurluler E, Alim A, Cakir U, Gurkan A. Total laparoscopic donor nephrectomy in situs inversus totalis: a case report. Exp Clin Transplant 2013; 11(2): 195−8.

van Dellen D, Ready AR, Inston NG. Hand-assisted laparoscopic donor nephrectomy in patients with aberrant inferior vena caval anatomy. Exp Clin Transplant 2010; 8(3): 258−61.

Douard R, Feldman A, Bargy F, Loric S, Delmas V. Anomalies of lateralization in man: a case of total situs inversus. Surg Radiol Anat 2000; 22(5−6): 293−7.

Tomić A, Jevtić M, Novak M, Ignjatović L, Zunić G, Stamenković D. Changes of glomerular filtration after nephrectomy in living donor. Int Surg 2010; 95(4): 343−9.