Renal Autotransplantation for The Treatment of Renal Artery Aneurysm

Machado, Marta; Machado, Rui; Almeida, Rui

doi:10.1016/j.avsg.2021.07.048

Cited by 5 publications

(6 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1,[11][12][13] However, most patients are asymptomatic and discover RAA as an incidental finding on imaging performed for an unrelated medical condition. 5,7 In the case of our patients, renal artery anomalies were found during preoperative imaging for potential living donations. Imaging and direct visualization of the renal vasculature during live donor kidney transplantations, found these to be true aneurysms.…”

Section: Introductionmentioning

confidence: 73%

“…1 Therapeutic options for treatment of RAA include endovascular or open surgery depending on anatomical considerations, surgeon experience, and the patient's comorbidities. 5,7 The arterial anatomy and location of the RAA determines the specific surgical technique in open repair, such as aneurysm plication, resection, exclusion, and bypass. [14][15][16] In the case of the potential living kidney donor with true renal artery aneurysm, a unique approach is posed in the treatment algorithm.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 RAA is more often found in Caucasian females, and is associated with fibromuscular dysplasia (FMD) in up to 60% of female patients. 4,5 Patients with RAA often lack traditional risk factors such as smoking history or chronic disease other than hypertension. 3 The risk for rupture is quite rare especially in the setting of conservative management, however is increased with pregnancy, size >3 cm, and when associated with inflammatory etiology.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Safety of Patients with Renal Artery Aneurysm to Proceed with Living Donation

Meshkin,

Kann,

Crane

et al. 2023

The American Surgeon™

View full text Add to dashboard Cite

Background Renal artery aneurysm (RAA) is a rare condition that involves dilation of all layers of the arterial wall of the renal artery. The risk of rupture is rare, but intervention is recommended for larger aneurysms. Surgical decision-making regarding live donor renal transplantation (LDRT) centers around safety for the living donor, and laterality of the donated kidney is based on providing the donor with the best longevity pertaining to the remaining kidney. We looked to review our long-term outcomes surrounding live donor transplants from donors with RAA with ex vivo resection and reconstruction prior to implantation. Methods A retrospective review was done of all laparoscopic live donor transplant nephrectomies with ex vivo aneurysm resection, reconstruction, and implantation at a single center. Results Three pairs of patients underwent successful laparoscopic donor nephrectomy, RAA resection, reconstruction, and transplantation of kidney. 2 males and 1 female ages 47 to 58 years of age underwent transplantation. The donors at 5 years of follow-up were noted to be functioning appropriately with no long-term sequelae of their donation and a mean remanent kidney function of 63 mL/min. Discussion For potential live donors with asymptomatic, unilateral renal artery aneurysm and no systemic disease, live donation with ex vivo resection and reconstruction can be performed with excellent long-term donor and recipient outcomes.

show abstract

Section: Introductionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Safety of Patients with Renal Artery Aneurysm to Proceed with Living Donation

Meshkin,

Kann,

Crane

et al. 2023

The American Surgeon™

View full text Add to dashboard Cite

show abstract

“…Nevertheless, it should be employed only when necessary. Choosing the appropriate material for vascular reconstruction constitutes a crucial decision [ 34 ]. Consistent with most series [ 23 , 35 ], our approach favors the use of the saphenous vein as the primary conduit for both arterial and venous reconstruction, followed by the superficial femoral vein for venous reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Nephrectomy with Autotransplantation—A Key Treasure

Mesquita,

Marques-Monteiro,

Madanelo

et al. 2024

JCM

Self Cite

View full text Add to dashboard Cite

Background: Nephrectomy with autotransplantation (NAT) has been performed as an alternative treatment for complex renovascular lesions, intricate ureteral strictures and nephron-sparing surgery in complex renal tumors. Methods: A retrospective observational study was conducted including patients who underwent a NAT from January 2010 to September 2023. Data collected included surgery indications, surgical technique, complications according to Clavien–Dindo classification and mean hospital stay. Descriptive and inferential statistical analysis was performed using IBM® SPSS® Statistics version 28.0.1.0. Results: A total of 34 consecutive patients underwent 38 NATs at our institution. Surgery indications were complex renovascular conditions in 35 cases (92.1%), of which 24 had renal artery aneurysms, and ureteral injuries in 3 cases (7.9%). Thirty-four kidneys (89.5%) were retrieved through a laparoscopic approach. No significant difference was observed between post- and pre-operative creatinine levels (0.81 vs. 0.72, p = 0.303). Early high-grade complications developed in 12 procedures (31.6%). Median cold ischemia time was significantly longer in patients who developed complications (163.0 vs. 115.0, p = 0.010). The median hospital stay was 10 days (8–13). The median follow-up was 51.5 months. Conclusions: NAT emerges as a successful therapeutic strategy for a highly select group of patients dealing with intricate ureteral lesions and kidney vascular abnormalities, demonstrating positive outcomes that endure in the long term.

show abstract

“…Renal autotransplantation has a high morbidity rate with relatively low mortality rate and can lead to significant improvement in quality of life and renal function preservation. Mortality ranges from 0.0% to 6.0% (Table 2) [4,78 ▪ ,91,119 ▪ ,122–131]. In a United Kingdom series, overall survival was 92% at 1-year, 87% at 3-years, 87% at 5-years, and 75% at 10-years whereas graft survival was 82% at 1-year, 3-years, 5-years, and 10-years [78 ▪ ].…”

Section: Complicationsmentioning

confidence: 99%

Indications for and results of renal autotransplantation

Han

Johnson

Schulster

et al. 2022

Current Opinion in Nephrology &Amp; Hypertension

View full text Add to dashboard Cite

Purpose of reviewTo understand the indications and outcomes of renal autotransplantation, and when to consider this unique procedure for patients. Recent findingsRenal autotransplantation confers acceptably low rates of graft failure and prevents need for long-term dialysis. Renal autotransplantation remains an important management strategy in very select patients for complex renovascular disease, ureteral stricture disease, ureteral trauma, upper urinary tract urothelial carcinoma, renal cell carcinoma, and Loin-Pain Hematuria Syndrome. With advancements in minimally invasive procedures, the application of renal autotransplantation for refractory stone disease is rare but exists. Robot-assisted laparoscopic renal autotransplantation demonstrates reproducible graft success and complication rates with improved perioperative outcomes (ex. hospital length of stay) --though comparative studies are lacking. Patients would benefit from a multidisciplinary approach from renal transplant surgeons, vascular surgeons, urologists, nephrologists, dieticians, pain management providers, social workers, and psychiatrists.

show abstract

Renal Autotransplantation for The Treatment of Renal Artery Aneurysm

Cited by 5 publications

References 16 publications

Safety of Patients with Renal Artery Aneurysm to Proceed with Living Donation

Safety of Patients with Renal Artery Aneurysm to Proceed with Living Donation

Nephrectomy with Autotransplantation—A Key Treasure

Indications for and results of renal autotransplantation

Contact Info

Product

Resources

About