Hem-o-lok clip dislodgment causing death of the donor after laparoscopic living donor nephrectomy.

The self-locking Hem-o-lok vascular clips (Weck Closure Systems, Research Triangle Park, NC) are widely used to control medium and large size vessels in various laparoscopic procedures (1). The self-locking mechanism ensuring adequate closure has made the Hem-o-lok clips popular mainly in laparoscopic donor nephrectomy (LDN) where the relatively short vascular stump remains with the donor (2). Another advantage is cost saving in comparison with the endovascular staplers. The following case report of late clip dislodgement with subsequent donor death has led to the recall in 2005 of the clip manufacturer not to use this clip in LDN (3), and indeed recent reports validated our observation (4). Despite that alert, these clips are still widely used in LDN in the United States (5) and Asia (6). This has prompted us to report that fatal case in the transplant literature.