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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Kidney transplantation remains the gold standard of treatment for patients with end-stage renal disease (ESRD), being strongly associated with the reduction of morbidity and mortality and improved quality of life. However, hemodialysis is associated with a heightened risk of thrombotic events which significantly contribute to central and peripheral venous occlusion. In such complex cases where conventional access to the iliac vessels is compromised, it becomes imperative that alternative sites for vascular anastomosis be taken into consideration. One may take the option of peritoneal dialysis into consideration given such a scenario, but the cost and need for technical skill for the successful execution of the procedure often makes it unattractive. A rare and promising option in a situation where the normal site of implantation and vascular access is a problem for a kidney transplant is the use of the splenic vessels following a splenectomy.
We describe the surgical management and follow-up of a 38-year-old male with End Stage Renal Disease secondary to hypertensive nephropathy with a hemodialysis vintage of 18 months. His clinical course was complicated by recurrent catheter-related thromboses involving his bilateral iliac, femoral, subclavian, and internal jugular veins. After CT angiography and vascular assessment revealed no suitable conventional anastomotic sites, orthotopic renal transplantation into the splenic bed was taken into consideration. The patient underwent a splenectomy, followed by implantation of the donor kidney with arterial and venous anastomoses to the splenic artery and vein, respectively. Uretero-ureterostomy was then performed over a stent.
Initially, the graft was placed in the retroperitoneal space but was repositioned into the splenic fossa due to poor perfusion. The repositioning was successful in allowing effective perfusion of the allograft. The patient’s postoperative recovery was uneventful and highlighted by progressive normalization of serum creatinine and improved urine output. The patient was discharged in good condition on day 7 postoperatively.
Current literature supports a strong association between dialysis-related hypercoagulability and thrombosis but also confirms that the splenic vasculature can serve as a viable inflow/outflow tract in a few select patients with inaccessible or poor central venous circulation.
This case demonstrates that in the face of extensive venous thrombosis of the iliac and femoral vessels, the splenic bed can serve as an effective site for renal allograft implantation. Due to lack of ready access and financial burden of peritoneal dialysis in Kenya, a multidisciplinary team decision was made to proceed with splenectomy and implantation of the graft in the splenic bed. With appropriate surgical expertise, this technique offers a life-saving alternative for patients who would otherwise be deemed unsuitable for transplantation due to lack of vascular access.
