Renal Autotransplantation for Localized Amyloidosis of the Ureter

Abstract

Localized amyloidosis of the ureter is a relatively rare disease, causing at times ureteral stenosis with hydronephrosis and renal function impairment to various extent. Although it is not malignant nearly all reported cases have been treated by nephroureterectomy because it is clinically difficult to differentiate this entity from ureteral malignancy. We report a case in which the ipsilateral kidney was salvaged successfully by renal autotransplantation. To the best of our knowledge, this is the first case reported of renal autotransplantation for localized amyloidosis of the ureter in the English literature. We suggest that renal autotransplantation be considered in cases of localized ureteral amyloidosis.

Anurea caused by primary amyloidosis of the lower third of the ureters, the ureterovesical junction and the urinary bladder

“…However, in bilateral ureter involvement, such an operation is not practically feasible, and alternative surgical techniques should be employed. Such operative techniques include resection with end-to-end anastomosis [10,11], autotransplantation [12], and ureter reimplantation [13].…”

Radiological findings of primary localized amyloidosis of the ureter

“…However, if amyloidosis can be diagnosed preoperatively, one of two conservative approaches can be used, to preserve functioning renal tissue. One is segmental resection of the ureter including resection with end‐to‐end anastomosis, ureteral reimplantation, autotransplantation, and ileal ureter replacement after confirming the pathology by frozen‐section examination (18, 19). The other is treatment with dimethyl sulfoxide (DMSO) after confirming the pathology by biopsy (20).…”

Bilateral localized amyloidosis of the ureters: clinicopathology and therapeutic approaches in two cases

“…A series of 31 cases with surgical treatment consisted of 18 with nephroureterectomy, 9 with ureterectomy and subsequent ureteroneocystostomy, 3 with renal autotransplantation, and 1 with ileal conduit surgery 17 . Thus, several techniques to preserve renal and/ or ureteral functions are available when localized amyloidosis of the ureter is confirmed before or at operation 15,17,18,19,20 . The second surgical therapy needs to be carefully selected especially in patients with sequential involvement of the bilateral ureters by this disease in order to maintain the function of the residual kidney 10,11,12,13 . There are a few reports dealing with medications: Kato et al used dimethyl sulfoxide for the occlusive segment of the ureter by a dressing technique and hydronephrosis was reported to disappear after 6 months 21 .…”