Renal autotransplantation for managing a short upper ureter or after <i>ex vivo</i> complex renovascular reconstruction

Webster, J. Christopher; Lemoine, J J; Seigne, John D.; Lockhart, Jorge L.; Bowers, Victor

doi:10.1111/j.1464-410x.2005.05729.x

Cited by 26 publications

(15 citation statements)

References 9 publications

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“…On the other hand, there are excellent long-term reports in publications on kidney auto transplantation [1,2,26,27,41]. In the largest of these studies with 27 patients, von Bodie et al were able to keep the kidney's function stable for 93% of the patients after kidney auto transplantation in a follow up time frame of 14 years [29].…”

Section: Discussionmentioning

confidence: 75%

Kidney Auto Transplantation: A Long Forgotten Technique?

Weig¹,

Schaarschmidt²,

Fornara³

et al. 2017

J Kidney

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Section: Discussionmentioning

confidence: 75%

Kidney Auto Transplantation: A Long Forgotten Technique?

Weig¹,

Schaarschmidt²,

Fornara³

et al. 2017

J Kidney

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“…After 14 years of follow-up, Bodie et al [20] reported functioning renal unit in 93% of the cases. Webster et al [21] also reported their experience in RAT in 4 patients with ureteric injuries caused by previous surgeries. Although, one of the autografts had to be removed due to renal vein thrombosis, the 3 remaining kidneys had a reasonable graft function at the end of the observed follow-up period.…”

Section: Discussionmentioning

confidence: 99%

“…If ureteral tissue loss is excessive, in addition to RAT there are other effective alternative treatment options that may be considered, including bladder mobilization (psoas hitch) with ureteric re-implantation, a Boari flap and ileal interposition surgery [21,22]. However, different types of tissues may be considered for the reconstruction of the ureter, especially in cases of a lack of healthy ileum.…”

Section: Discussionmentioning

confidence: 99%

Renal Autotransplantation at Three Academic Institutions in Turkey

et al. 2016

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Objective: The objective of this study is to present the experience of 3 institutions performing renal autotransplantation (RAT) and to discuss surgical techniques employed and the results in the light of the medical literature. Materials and Methods: A total of 14 patients (11 male and 3 female) with a mean age of 47 ± 8 years (35-61 years), who underwent RAT procedure at 3 different institutions between October 2006 and November 2014, in Turkey, were evaluated retrospectively. Indications for RAT procedure are ureteral avulsion, renal artery aneurysm and intimal dissection caused by percutaneous transluminal renal artery angioplasty (PTRA). Twelve patients with ureteral avulsion, 1 patient with renal artery aneurysm and 1 patient with intimal dissection caused by PTRA were followed-up for 103 months. Seven (50%) open and 7 (50%) laparoscopic nephrectomies were performed. Nine patients (64.3%) were right-sided and 5 patients (35.7%) were left-sided. Complications of grade III and above as per Clavien-Dindo classification were assessed. Results: Mean time from injury to RAT was 21.2 ± 40.1 days. However, 5 (35.7%) patients were treated on the same day of the injury. As per Clavien-Dindo classification, 2 (14.2%) grade IVa and 1 (7.1%) grade IIIa complications were reported. However, no significant correlation was observed between the complications and graft loss regarding type and side of the nephrectomy performed (p = 0.462 and p = 0.505, respectively) and timing of the intervention (p = 0.692). Conclusion: RAT is a safe procedure in combination with minimally invasive laparoscopic technique in carefully selected patients; however, it requires expertise and proficiency in laparoscopy, reconstructive urology and transplantation. Nevertheless RAT should be considered as the last resort, when other modalities fail.

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“…7 They reported no statistical difference in creatinine level before and after surgery in either group. Seki and associates also reported that split renal function is stable or improved after ex vivo revascularization and autotransplant for renal artery aneurysms.…”

Section: Discussionmentioning

confidence: 99%

“…4 In addition, these procedures in combination can provide an effective opportunity to safely repair the artery. 7 This is why we selected nephrectomy, ex vivo repair of the renal artery, and renal autotransplant. The present patient showed normal serum creatinine and blood urea nitrogen levels at a 32-month postoperative follow-up.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Nephrectomy, Ex Vivo Angioplasty, and Renal Autotransplant for a Renal Artery Aneurysm: A Case Report

Ogawa¹,

Yanagida²,

Kataoka³

et al. 2012

Exp Clin Transplant

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We describe in this report the case of a renal aneurysm in a 42-year-old woman. The aneurysm measured 27 mm in diameter, and was sited at the first bifurcation of the renal artery. We performed laparoscopic nephrectomy, ex vivo angioplasty and renal autotransplant to avoid ischemic damage to the kidney during reconstruction. The patient recovered and was discharged from the hospital without any complications. Hence, we suggest these treatments can be effectively done in patients with complex renal aneurysms. Key words: Renal artery aneurysm, Laparoscopic nephrectomy, Extracorporeal reconstruction, Renal autotransplantation, Renal functionSince renal autotransplant was first described by Hardy in 1963, 1 it has been used to treat patients with renovascular diseases, ureter injuries, and renal tumors. We present the case report of a patient with a renal artery aneurysm who underwent nephrectomy, ex vivo angioplasty of the renal artery, and renal autotransplant who recovered without complications. Case ReportA 42-year-old woman visited the district general hospital, complaining of a history of continuous fever and fatigue. Her urine was clear; however, results of screening abdominal ultrasonography revealed a hypoechoic mass in the upper part of the right kidney. Doctors there suspected a right renal artery aneurysm and referred her to our hospital. On admission, her blood pressure was normal, and serum creatinine and blood urea nitrogen concentrations were within normal ranges. Results of 3-dimensional computed tomography (CT) and selective renal angiography showed a saccular right renal artery aneurysm measuring 27 mm in diameter (Figures 1 and 2). From these images, we also ascertained that the aneurysm originated from the first bifurcation of the renal artery. Results of a subsequent renogram showed normal split renal function of the bilateral kidney. The CT and angiography results indicated that endovascular coil embolization was impossible, owing to the morphology and site of the aneurysm. Based on these findings, the patient was scheduled for laparoscopic nephrectomy, ex vivo repair, and autotransplant.The patient was placed in the lateral decubitus position with the left side down. Three 12-mm ports and a 5-mm port were inserted into the retroperitoneal space. After dissection of the renal hilum, the right renal artery and the aneurysm were

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Renal autotransplantation for managing a short upper ureter or after ex vivo complex renovascular reconstruction

Cited by 26 publications

References 9 publications

Kidney Auto Transplantation: A Long Forgotten Technique?

Kidney Auto Transplantation: A Long Forgotten Technique?

Renal Autotransplantation at Three Academic Institutions in Turkey

Laparoscopic Nephrectomy, Ex Vivo Angioplasty, and Renal Autotransplant for a Renal Artery Aneurysm: A Case Report

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