Adult polycystic kidney disease (APKD) accounts for 2% of end-stage renal disease in Singapore and is a major indication for kidney transplantation. We report synchronous nephrectomy with unilateral cadaveric dual kidney transplantation (DKT) in a patient with APKD. Simple nephrectomy of the right native 27-cm polycystic kidney was performed to provide adequate space for unilateral DKT. Right donor kidney transplantation was performed at the site of native nephrectomy. End-to-side anastomosis of the right donor renal vein to the distal inferior vena cava and the right donor artery to the common iliac artery were performed. Left donor kidney was transplanted below the right kidney, with its vessels anastomosed to the right external iliac vessels. Ureter anastomosis was performed after perfusion of both kidneys. Lich-Gregoir anastomosis of the left donor ureter to the bladder and direct right donor ureter to native ureter anastomosis was established. This case illustrates that synchronous nephrectomy with DKT is feasible to facilitate implantation on the same side.
Adult ; Anastomosis, Surgical ; Humans ; Kidney ; surgery ; Kidney Failure, Chronic ; surgery ; Kidney Transplantation ; methods ; Male ; Middle Aged ; Nephrectomy ; methods ; Polycystic Kidney, Autosomal Dominant ; surgery ; Tomography, X-Ray Computed ; Ureter ; surgery

Nonalcoholic fatty liver disease (NAFLD) is characterized by hepatic steatosis caused by nonalcoholic factors, and its pathogenesis, progression, treatment, and prevention have attracted more and more attention. At present, an increasing number of studies have been conducted on the association of intestinal microecology with various metabolic diseases such as obesity, diabetes, and cardiovascular diseases. Recent studies have found that butyrate, a metabolite of intestinal flora, is closely associated with NAFLD and can affect the development and progression of NAFLD through various mechanisms, such as alleviating inflammatory response, inhibiting insulin resistance, and reducing oxidative stress of liver mitochondria. Exploration of the association between butyrate and NAFLD is expected to provide a new approach for the prevention and treatment of NAFLD.