Use of Hypothermic Machine Perfusion to Identify Anatomic Variation Before Transplantation of a Pancake Kidney: A Case Report

Pancake kidneys are rarely used in transplantation due to their low incidence (<1/50？000) and complex anatomy.1-3 Unrecognized vasculature can lead to bleeding or partial graft infarction if inappropriately managed, and unrecognized ureters can lead to urine leak or obstruction. Although the number may be small, fused kidneys doubtlessly contribute to deceased donor kidney discards that are categorized as anatomical abnormalities.