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31 December 2012

Renal autotransplantation – a possibility in the treatment of complex renal vascular diseases and ureteric injuries

Hans Michael HauABCDEF, Michael BartelsABCDEF, Hans-Michael TautenhahnBC, Mehmet Haluk MorgulBC, Peter FellmerF, Phuc Ho-ThiF, Christoph BenckertCD, Dirk UhlmannCF, Michael MocheBC, Armin ThelenDF, Moritz SchmelzleBCD, Sven JonasAE

DOI: 10.12659/AOT.883690

Ann Transplant 2012; 17(4): 21-27

Abstract

Background: We report our contemporary experiences with renal autotransplantation in patients with complicated renal vascular diseases and/or complex ureteral injuries. Since its first performance, renal autotransplantation has been steadily improved and become a safe and effective procedure.
Material/Methods: Between 1998 and 2006, 6 renal autotransplantations in 6 patients were performed at the University Medical Center of Leipzig. After nephrectomy and renal perfusion ex vivo, the kidney was implanted standardized in the fossa iliaca. The vessels were anastomized to the iliac vessels, the ureter was reimplanted in an extravesical tunneled ureteroneocystostomy technique according to Lich-Gregoir. Demographic, clinical, and laboratory data of the patients were collected and analyzed for pre-, intra-, and postoperative period.
Results: Indications for renal autotransplantation were complex renovascular diseases in 2 patients (1 with fibromuscular dysplasia and 1 with Takayasu’s arteritis) and in 4 patients with complex ureteral injuries. The median duration of follow-up was 9.7 years (range: 5.6–13.3). The laboratory values of our 6 patients showed improvements of creatinine, urea and blood pressure levels in comparison to the preoperative status at the end of follow-up period.
Conclusions: The present study reports excellent results of renal autotransplantation in patients with renovascular disease or complex ureteric injuries. After a median follow-up of 9.7 years all 6 patients present with stable renal function as well as normal blood pressure values. Postoperative complications were observed with a rate comparable to other studies.

Keywords: Renal autotransplantation, ureteric injury, Hypertension, Renovascular

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358