Premium
Experience in renal autotransplantation:
Author(s) -
Plas E.,
Kretschmer G.,
Stackl W.,
Steininger R.,
Mühlbacher F.,
Pflüger H.
Publication year - 1996
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1046/j.1464-410x.1996.09336.x
Subject(s) - medicine , renovascular hypertension , renal function , autotransplantation , nephrectomy , kidney , creatinine , urology , surgery , urinary system , thrombosis , transplantation
Objective To determine the benefit of renal autotransplantation in selected patients with either renovascular lesions, renal or urothelial carcinomas or other disorders of the urinary collecting system. Patients and methods Between 1977 and 1994, 12 patients underwent renal autotransplantation, six involving renovascular hypertension, two involving tumours of the renal parenchyma, two with urothelial tumours and two with long ureteric stenoses. Pre‐operative renal function was normal in six patients and impaired in five. One patient was on haemodialysis. Five patients had a solitary kidney and four patients had functionally solitary kidneys. The follow‐up period ranged from 1 to 93 months (mean 34.9). Results Post‐operatively, six patients had normal kidney function (serum creatinine ≤12 mg/L), five patients had impaired renal function (creatinine content ≤26 mg/L) and one patient was on haemodialysis due to arterial graft thrombosis. Serum creatinine levels improved in four patients and were stable in another four. Renal function deteriorated in three patients and one patient required a graft‐nephrectomy. Immediate post‐operative complications included arterial thrombosis in one patient, perirenal haematoma in two, pulmonary oedema in one and severe intra‐operative bradycardia requiring a transient cardiac pacemaker in one. Conclusion Renal autotransplantation represents an effective alternative treatment with good long‐term results for selected patients with long ureteric lesions and renovascular disorders. It is also an effective method for patients with urological malignancies, especially those with solitary kidneys where the maintenance of renal function is of major concern.