CPT® Code 50360

The procedure described by CPT® Code 50360 refers to renal allotransplantation, specifically the implantation of a kidney graft without the removal of the recipient's native kidney. In this surgical procedure, a kidney, which may be obtained from either a deceased (cadaver) or living donor, is transplanted into a patient who requires a new kidney due to renal failure or other kidney-related conditions. The operation begins with an incision in the lower abdomen, allowing access to the retroperitoneal space where the iliac blood vessels are located. The surgeon carefully dissects and prepares these blood vessels to facilitate the connection of the donor kidney's blood supply. The procedure involves meticulous steps, including the ligation and division of lymphatic vessels, dissection of the iliac blood vessels, and the application of vascular clamps to control blood flow during the anastomosis. The renal vein and renal artery from the donor kidney are then surgically connected to the recipient's external iliac vein and internal or external iliac artery, respectively. If the donor kidney has multiple veins or arteries, each is connected separately to ensure adequate blood supply. Following the vascular connections, the ureter from the donor kidney is prepared for attachment to the recipient's bladder, which involves exposing and incising the bladder dome. The ureter is then trimmed and anastomosed to the bladder, with the possibility of placing a temporary stent to maintain patency at the connection site. Finally, the transplanted kidney is positioned in the parapsoas fossa, ensuring that the blood vessels and ureter are not kinked, and the surgical incisions are closed. This procedure is reported using CPT® Code 50360 when the transplant is performed without nephrectomy of the recipient's kidney.