Introduction.

We present a patient with chronic renal failure secondary to bilateral hydroureteronephrosis with a history of prune belly syndrome, who underwent a kidney transplant. The objective of this case report is to expose a congenital anomaly, with a low worldwide incidence and to a lesser extent associated with kidney transplantation, with emphasis on the difficulty for the surgical technique due to the hypoplasia of the abdominal wall muscles.

Methods.

Review of clinical history, Informed Consent. Literature search.

Clinical case.

Absence of abdominal wall muscles and fibrosis of the external iliac veins and right common veins were identified intraoperatively. An approach was performed under the contralateral Gibson technique, with uncomplicated kidney transplantation. He presented adequate evolution in outpatient follow-up.

Discussion.

Prune belly syndrome is a low-incidence congenital anomaly, with few reports associated with kidney transplantation. The surgical challenge is given by the absence of abdominal wall muscles, which increases the risks due to possible complications, such as injury to the inferior epigastric vessels. For the closure of the abdominal wall in kidney transplantation, it is described in two planes, which in this case is performed on muscle fascia and skin. Despite being a challenge, the patient has adequate postoperative evolution.

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