Torsion of the renal pedicle due to rotation of the kidney after simultaneous kidney-pancreas transplantation

Torsion of a renal transplant around its pedicle is a rare complication, which has been described in renal transplant children with Prune Belly syndrome, but also exceptionally in adults undergoing kidney-pancreas transplantation. One of the diagnostic difficulties is due to the lack of specificity of the clinical features in some cases, which may lead to delayed diagnosis and loss of the kidney due to renal pedicle thrombosis. The authors report a case of a 31-year-old woman undergoing simultaneously kidney-pancreas transplantation, who developed torsion of the renal pedicle following intraperitoneal rotation of the renal transplant several months after transplantation. They discuss the diagnosis and prevention of this exceptional complication.