Renal autotransplantation using hypothermic storage and pulsatile perfusion

Area of Science:

• Nephrology
• Vascular Surgery
• Hypertension Management

Background:

• Severe hypertension can be secondary to renal artery stenosis.
• Complex renal artery stenosis cases pose treatment challenges.

Purpose of the Study:

• To evaluate the efficacy of renal autotransplantation in patients with severe hypertension due to renal artery stenosis.
• To assess the benefits of hypothermic preservation during renal autotransplantation.

Main Methods:

• Renal autotransplantation with hypothermic kidney preservation was performed in three patients.
• This technique was chosen over conventional methods for improved ischemia time and surgical exposure.
• Postoperative management included intravascular volume expansion.

Main Results:

• Two of three patients achieved sustained normotension without antihypertensive medication for 9 and 12 months.
• One patient experienced a fatal outcome due to septicemia unrelated to the transplant procedure.
• All patients required fluid volume expansion post-surgery to counteract vasoconstrictor loss.

Conclusions:

• Renal autotransplantation is a viable treatment for severe hypertension secondary to complex renal artery stenosis.
• Hypothermic preservation facilitates complex renal vascular reconstructions.
• Careful postoperative fluid management is crucial following renal autotransplantation.