Polycystic horseshoe kidney

A 57-year-old man presented for a living unrelated kidney transplant. His end-stage kidney disease was secondary to autosomal dominant polycystic kidney disease, and he was coincidentally noted to have a horseshoe kidney on abdominal imaging (Figure 1). He had been maintained on hemodialysis for 11 months before transplant. Because of the massive fused kidneys, a bilateral native nephrectomy was required before transplant to create room in the abdomen for the donor organ. Concurrent open nephrectomy and renal transplant were performed (Figure 2; Supplementary Figure S1). Figure 2Fused polycystic kidney measuring 33.5 cm superior to inferior × 30 cm medial to lateral. View Large Image Figure Viewer Download Hi-res image