Inferior Vena Cava Resection Using Modified Veno-Venous Bypass With Renal Vein Drainage: Case Report Adapted From Liver Transplant Practice.
Guido Fallani, Alice Assirelli, Matteo Ravaioli et al.
✦ AI-curated · Sources linked
Case in brief
A patient with recurrent renal cell carcinoma invading the inferior vena cava (IVC) and left renal vein confluence had a solitary kidney after right nephrectomy. The patient underwent radical tumor resection and IVC reconstruction using a modified three-arm veno-venous bypass adapted from liver-transplant practice. An additional cannula drained the left renal vein during IVC clamping, maintaining renal venous outflow and limiting kidney warm ischemia to 14 minutes. Recovery was uneventful, with only a transient minimal creatinine elevation and no acute kidney injury.
What made this case unusual
The bypass circuit was modified with a direct left renal vein drainage limb, adapting a liver-transplant technique to support renal outflow during IVC reconstruction in a patient with a solitary kidney.
Diagnostic / clinical pearl
When IVC clamping is required for reconstruction in a patient with a solitary kidney, direct renal venous drainage through a modified bypass circuit may help limit warm ischemia.