Published online Aug 26, 2020. doi: 10.12998/wjcc.v8.i16.3548
Peer-review started: April 6, 2020
First decision: April 24, 2020
Revised: May 1, 2020
Accepted: July 16, 2020
Article in press: July 16, 2020
Published online: August 26, 2020
Processing time: 140 Days and 18.4 Hours
Pelvic lipomatosis is a rare disease of unknown etiology, characterized by the overgrowth of pelvic adipose tissue that causes compression of the urinary tract including the bladder and ureters, rectum and blood vessels. The patient may progressively develop obstructive uropathy which could subsequently lead to renal failure. At present, there are no reports of renal transplantation due to uremia caused by pelvic lipomatosis. The ideal management of patients with pelvic lipomatosis after renal transplantation is not yet well-established due to the lack of literature and follow-up data.
We report a 37-year-old male patient with pelvic lipomatosis who received a successful living donor renal transplantation on July 22, 2015. The operation was complicated as the iliac vessels and bladder were wrapped entirely in excessive abnormal fat. The external iliac artery and vein were located using ultrasonographic guidance. The adipose tissue around the right bladder was removed as far as possible, and the graft ureter was reimplanted into the bladder, using the Lich-Gregoir technique. At 22 mo after transplantation, graft percutaneous nephrostomy was performed under ultrasonographic guidance for urinary diversion due to hydronephrosis of the graft kidney. Follow-up at four years showed that the renal allograft function was stable.
When patients with pelvic lipomatosis develop renal failure, renal transplantation could be a feasible treatment strategy.
Core tip: We describe a patient with pelvic lipomatosis who underwent renal transplantation due to uremia. Such patients may progressively develop obstructive uropathy which can subsequently lead to renal failure. At present, there are no reports of renal transplantation due to uremia caused by pelvic lipomatosis. The ideal management of patients with pelvic lipomatosis after renal transplantation is not yet well-established due to the lack of literature and follow-up data.