Case Report of First Kidney Transplant in Mexico Using Horseshoe Kidney from a Cadaveric Donor in a Single Recipient

Introduction: Horseshoe kidneys are the most common fusion defect of the kidneys, with a reported frequency of approximately 1:500. They are characterized by anomalies in the position, rotation and vascular supply of the kidney. Case Description: The recipient was a 51-year-old female patient, with a history of chronic kidney disease of unknown etiology diagnosed in 2012, she received a first kidney transplant from a deceased donor in 2014. She entered to transplant protocol for a 2nd kidney transplant in 2019 with eGFR CKD EPI 13 ml/min/1.73m2. A horseshoe kidney transplant with 2 arteries and 2 veins per kidney, a infraumbilical laparotomy approach was performed, bloc implant with arterial anastomosis to the right common iliac artery and venous anastomosis to the infrarrenal cava, induction immunosuppression was with thymoglobulin and methylprednisolone. She presented spontaneous uresis after graft reperfusion, she was discharged on March 12, 2024, with creatinine 0.4 mg/dl. Discussion: There is little evidence of related cases of kidney transplant associated with horseshoe kidney, there are case reports that show en bloc transplantation to 2 recipients, unlike our case that includes a single recipient. Currently considered technically and biochemically successful, long-term surveillance continues to assess graft survival and whether there are complications associated with using this type of graft with anatomical variant, since they have been associated with associated syndromes and subsequent malignancy.