Renal autotransplantation for vascular disease: Late outcome according to etiology

Abstract

RAT is highly effective for treatment of complex renovascular lesions related to FMD and TD. Although RAT is less effective for atherosclerosis, it may be the only alternative in cases involving extensive renovascular disease.

Fibromuscular Dysplasia: State of the Science and Critical Unanswered Questions

“…54,[240][241][242][243] Ex vivo renal revascularizations are usually reserved for complex occlusive or aneurysmal disease affecting branch vessels. 244,245 Nonanatomic bypass procedures are an important therapeutic option in treating select patients with renovascular hypertension. [246][247][248][249] The hepatic artery or iliac arteries may be used as sites of origin for bypass grafts to the renal artery, especially when originating a graft from the aorta would entail unacceptable risk.…”

Kidney Auto Transplantation: A Long Forgotten Technique?

“…With these indications, kidney auto transplantation is always applicable when other surgical procedures or intravasal interventional procedures, such as the PTA, are not auspicious. From this point of view there are a row of publications that, such as the kidney auto transplantation under urological indication, are accompanied by excellent long-term results [5,6,[42][43][44]. In this field, kidney auto transplantation has a fixed standing.…”

“…Since this time, cases and studies which report good long term results with a selected group of patients have been published regularly. These patients usually suffer from long ureteral lesions, metabolic stone disorders, complex vascular and Reno vascular disorders and diverse malignoma [2][3][4][5][6]12,14,26,27]. In the care of experienced transplantation surgeons, kidney auto transplantation is a safe and efficient procedure to treat the above mentioned disorders.…”

“…Exspecially for abdominal aortic aneurysms the PTA is the method of choice which reduced the risk to lose the patient's life, whenever the danger of the loss of kidney function had increased. Because of this fact it is useful to inform the transplant unit about the intervention so a auto transplantation can be planed as the rescue therapy for the kidney function, even in single complicated renovascular disorders (isolated occlusive fibrodysplasia, arteriosclerotic lesions of the kidney artery, or inflammatory lesions) with which PTA does not promise success, or could even be dangerous, auto transplantation is a safe alternative [5][6][7][8][9][10].…”

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“…Chiche and associates reported a series of 68 renal autotransplants performed for renovascular disease. 9 Indications included fibromuscular dysplasia in 34 procedures, Takayasu disease in 26 procedures, and atherosclerosis in 8 procedures. The renal lesions were aneurysmal, occlusive, or both aneurysmal and occlusive.…”