Renal scintigraphy of an infarction in an en bloc transplantation of a horseshoe kidney

A 30-year-old woman with end stage renal disease received a cadaveric horseshoe kidney transplant. The horseshoe kidney embryologically represents the fusion of the lower poles of the kidneys in 95% of occasions. Another characteristic is the abnormal blood supply thought to be persistent from the embryonic period. Because each renal artery supplies its own area, there is no collateral circulation between the area-an artery ligated by accident will always cause an infarction. This often happens in the fusion bridge, which receives its separate blood vessels from the distal aorta, or even the lilac artery.