Repeat kidney transplant in a patient with a double inferior vena cava and difficult venous access: A case report

Shira Stern, Hadar Merhav, Samir Abu Gazala, Allan Isaac Bloom, Tawfik Khoury, Irit Mor-Yosef-Levi, Michal Elhalel-Dranitzky, Keren Tzukert, Abed Khalaileh*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Many obstacles may complicate renal transplant, the preferred treatment for end-stage renal disease. Anatomic anomalies are of special importance during surgery. Double inferior vena cava is a rare anomaly reported in 0.2% to 3% of the population and may complicate renal transplant in certain cases. We present a case of a 29-year-old man with end-stage renal disease who was scheduled for repeat kidney renal transplant from a living related donor. His transplant posed many challenges to the transplant team. These included (1) difficult access for dialysis, which required transhepatic insertion of a dialysis catheter, (2) anomalous inferior vena cava anatomy with a double inferior vena cava, (3) a blocked right inferior vena cava, and (4) a small blocked bridging vein connecting the right inferior vena cava to an additional left inferior vena cava. A stent was inserted into the bridging vein to allow venous drainage from the graft. During the transplant procedure, the donated kidney was transplanted into the left iliac fossa and anastomosed to the left external iliac vein. The surgery was successful, without major operative or postoperative complications. The patient was discharged with normal renal function and enjoys normal renal function 6 months after surgery. This case emphasizes the importance of pretransplant evaluation and preparation and the need for high index of suspicion for anatomic variants in donors and recipients.

Original languageAmerican English
Pages (from-to)382-384
Number of pages3
JournalExperimental and Clinical Transplantation
Issue number3
StatePublished - Jun 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© Başkent University 2020.


  • Access
  • Anatomic anomalies
  • Renal transplantation


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