University of Rijeka. Faculty of Medicine. Department of Urology.
Abstract
Potkovičasti bubreg najčešća je kongenitalna bubrežna anomalija koja nastaje fuzijom dijelova bubrega, najčešće njegovih donjih polova. Većina pacijenata s ovom anomalijom je asimptomatska, ali je primijećena povećana incidencija nekih drugih patoloških stanja i anatomskih abnormalosti. Prve transplantacija bubrega krenule su prije 100-tinjak godina, a prva zabilježena transplantacija potkovičastog bubrega tek pred 44 godine. Potkovičasti bubreg može se previdjeti na ultrazvučnim pregledima potencijalnih darivatelja, tako da se često utvrdi tek drugim radiološkim metodama ili čak tijekom eksplantacije. Transplantaciju je moguće izvesti en bloc ili podijeliti bubreg na dva dijela te presaditi svaki zasebno. Prilikom izvođenja resekcije istmusa od presudne je važnosti kvalitetna i precizna procjena krvožilnog sustava i kanalnog sustava presatka. Obje metode, kao i presađivanje bubrega normalne anatomije pokazuju iste rezultate posttransplantacijskog praćenja. Presađivanje potkovičastog bubrega pruža mogućnost smanjivanja listi čekanja na transplantaciju i svakako zaslužuje svoje mjesto u transplantacijskoj medicini.Horseshoe kidney is the most common congenital renal anomaly which is result of a fusion of kidney's two parts, usually its lower poles. The majority of patients with this anomaly are asymptomatic, but higher incidence of other pathological conditions and anatomic abnormalities is noticed. First kidney transplantations occurred around 100 years ago, and the first one of the horseshoe kidney is noted only 44 years ago. Horseshoe kidney can be overlooked on an ultrasound evaluation of potential organ donor, so it is often determined only by other radiological methods or even during the explantation. The transplantation can be performed en bloc or the kidney can be splitted and transplanted separately. While resecting isthmus it is crucially important to make precise assessment of vascular and collecting urinary system of the graft. Both methods, as well as the transplantation of the kidney of a normal anatomy show the same results of a posttransplantation follow up. Transplantation of a horseshoe kidney offers a possibility to reduce waiting lists and certainly deserves its place in the transplantation medicine
