Transplant: Italian surgeons implant a kidney instead of the spleen

In a little girl with a rare kidney and abdominal blood vessel defect, surgeons had to transplant a kidney instead of her spleen.

This is not a medical error, but a world first. On the night of December 9 to 10, 2016, the kidney transplant team at Molinette Hospital in Turin (Italy) transplanted a kidney instead of the spleen of a 6-year-old girl.

Surgeons were made to imagine this unusual procedure due to the rare kidney and vascular malformations the girl suffered from. Serious abnormalities that have forced her to be on dialysis since birth. They also deprived her of drinking and urinating.

A first transplant had already been attempted in 2014. But the abnormality of these abdominal blood vessels caused the transplant to fail. The organ, which was not receiving blood, never functioned properly. In addition, his immune system reacted strongly against the transplant, the hospital said in a statement.

As a result, the doctors had to perform several genetic tests to find a donor “highly compatible” with the small patient. The perfect donor was found on December 9th.

Successful operation

But even once this hurdle is cleared, surgeons face yet another pitfall. “Its malformation is so particular that it makes it impossible to transplant a new kidney with the usual techniques”, explained the establishment. The only possibility for surgeons is to implant the kidney higher in the abdominal cavity in order to recreate a new connection to the vascular network.

They then decide to implant the graft in place of the spleen, a dispensable organ located deep in the abdomen, very close to the ribs. Thanks to a very long ureter, the surgeons were able to connect the kidney to the little girl’s bladder.

After a few days in intensive care, the young patient is doing very well. For the first time, she was able to drink and pee without a catheter at 6 years old. She should soon be transferred to the kidney transplant department of another hospital.