{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T12:00:41Z","timestamp":1776254441741,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Horseshoe kidney (HSK) is a rare congenital fusion anomaly that poses distinct anatomical and surgical challenges in kidney transplantation. Owing to its low incidence, evidence on long\u2010term outcomes remains limited. This study reports a 20\u2010year single\u2010center experience with HSK transplantation, comparing en bloc and split grafts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on six HSK transplants from deceased donors performed since January 2005. All recipients had end\u2010stage renal disease and were undergoing dialysis at transplantation. The choice between en bloc or split implantation was based on vascular, isthmic, and collecting system anatomy. Primary outcomes included graft function, patient survival, and postoperative complications; secondary outcomes were delayed graft function (DGF) and long\u2010term renal function. Descriptive statistical analysis was applied to perioperative and follow\u2010up data, including serum creatinine (SCr) and graft survival up to 20 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among six recipients (three en bloc, three split), one en bloc recipient died on postoperative Day 3 due to bowel infarction. The remaining five patients showed immediate graft function, except one with DGF. At a mean follow\u2010up of 14 years, all surviving recipients maintained satisfactory renal function (mean SCr = 130\u00a0\u00b5mol\/L). No graft loss or major surgical complications were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HSK transplantation, though technically demanding, represents a viable strategy to expand the donor pool. With careful anatomical assessment and surgical planning, both en bloc and split grafts can achieve excellent long\u2010term outcomes. However, en bloc transplantation may entail greater procedural and spatial challenges, emphasizing the need for accurate recipient selection and size matching.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70460","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T13:17:24Z","timestamp":1768828644000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Transplantation of Horseshoe Kidneys: Surgical Strategies and 15\u2010Year Functional Outcomes From a Tertiary Center Experience"],"prefix":"10.1111","volume":"40","author":[{"given":"Francesco","family":"Nacchia","sequence":"first","affiliation":[{"name":"Kidney Transplantation Unit, Azienda Ospedaliero Universitaria Integrata  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0260-4601","authenticated-orcid":false,"given":"Riccardo","family":"Bertolo","sequence":"additional","affiliation":[{"name":"Urology Unit, Department of Surgical Sciences, University of Verona, Azienda Ospedaliero Universitaria Integrata  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7263-2985","authenticated-orcid":false,"given":"Rostand Emmanuel Nguefouet","family":"Momo","sequence":"additional","affiliation":[{"name":"Kidney Transplantation Unit, Azienda Ospedaliero Universitaria Integrata  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Donato","sequence":"additional","affiliation":[{"name":"Kidney Transplantation Unit, Azienda Ospedaliero Universitaria Integrata  Verona 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Unit, Azienda Ospedaliero Universitaria Integrata  Verona Italy"},{"name":"Urology Unit, Department of Surgical Sciences, University of Verona, Azienda Ospedaliero Universitaria Integrata  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"B.Da Carpi Isagogae Breves Perlucide ac Uberrime in Anatomiam Humani Corporis National Library of Medicine (Woodcut 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