[Orthotopic renal transplant: our experience]

Area of Science:

• Nephrology
• Transplant Surgery
• Vascular Surgery

Background:

• Orthotopic renal transplant (ORT) is indicated for specific complex cases, including severe atherosclerosis, unsuitable pelvic vasculature, and aortic thrombosis.
• However, ORT is not universally available and is performed infrequently.

Observation:

• This study reviewed five cases of ORT performed between January 1990 and December 2005.
• Data analyzed included patient demographics, donor characteristics, ischemia times, renal function, and morbidity/mortality.
• The mean patient age was 52 years, with all recipients receiving kidneys from cadaveric donors.

Findings:

• One-year graft and patient survival rates were 80%.
• Postoperative renal function showed improvement, with mean creatinine levels decreasing from 2.2 mg/dl at one month to 1.8 mg/dl at six months.
• Complications included one graft loss due to bleeding, two hospital readmissions for unrelated issues, and asymptomatic renal artery stenosis in four patients.

Implications:

• ORT presents an excellent alternative for patients with increased comorbidities, particularly atherosclerosis, who are not candidates for traditional iliac fossa transplantation.
• Careful patient selection and management are crucial for optimizing outcomes in ORT.