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Case report
Living donor hand-assisted laparoscopic nephrectomy in a healthy individual with situs inversus totalis: no need to turn down the donor
  1. Stan Benjamens1,2,
  2. Tamar Alice Johanne van den Berg1,
  3. Johan Frédéric Michel Lange1 and
  4. Robert Alexander Pol1
  1. 1Surgery, Universitair Medisch Centrum Groningen, Groningen, Netherlands
  2. 2Medical Imaging Center, Universitair Medisch Centrum Groningen, Groningen, Netherlands
  1. Correspondence to Stan Benjamens; s.benjamens{at}


A 70-year-old healthy male individual offered to undergo a living donor hand-assisted laparoscopic nephrectomy to enable kidney transplantation for a close relative. As required for all living transplant donor candidates, extensive screening was performed to exclude potential contraindications for donation. Tests revealed a situs inversus totalis, meaning a complete transposition of the thoracic and abdominal organs in the sagittal plane. As other contraindications for living kidney donation were absent, the feasibility of this procedure was determined multidisciplinary. A successful donation procedure was performed without surgical complications for the donor and good short-term transplant outcomes. In line with current developments that have resulted in more liberal criteria for potential living kidney donors, major anatomical deviations should not automatically be a contraindication. With multidisciplinary efforts and thorough surgical preparation at a high-volume transplant centre, this procedure is feasible and safe.

  • transplantation
  • surgery
  • renal medicine
  • renal transplantation

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  • SB and TAJvdB are joint first authors.

  • Contributors SB and TAJvdB (shared first authors—both authors contributed equally) were involved in writing the manuscript and acquiring the medical images. JFML and RAP performed the described procedure and contributed to the final adjustments to the manuscript after revising it critically for intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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