Irreversible renal failure following right nephrectomy and left renal vein ligation.

Ligation of the left renal vein has been advocated in certain clinical situations and venous outflow then is dependent on an adequate collateral venous system. We report on a child who suffered complete renal failure after ligation of the left renal vein in association with right nephrectomy and, subsequently, died. The left renal vein should be repaired in the presence of a solitary left kidney to prevent renal vein thrombosis and subsequent renal failure. This is particularly true in children in whom venous collateral circulation of the left kidney may not be well developed.