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Renal autotransplantation.

A Flatmark, D Albrechtsen, G Sødal

    World Journal of Surgery
    |March 1, 1989
    PubMed
    Summary
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    Renal autotransplantation with extracorporeal repair is a safe and effective treatment for complex kidney conditions like renovascular disease and kidney stones. This procedure demonstrated low mortality and graft loss rates in selected patients.

    Area of Science:

    • Urology
    • Nephrology
    • Transplantation Surgery

    Background:

    • Renal lesions, including fibromuscular dysplasia, atherosclerotic disease, nephrolithiasis, tumors, and ureteral injuries, pose significant treatment challenges.
    • A substantial proportion of patients with these conditions exhibit reduced renal function and severe hypertension, complicating management.

    Purpose of the Study:

    • To evaluate the safety and efficacy of renal autotransplantation, often combined with extracorporeal repair, for managing complex renal pathologies.
    • To assess outcomes including postoperative mortality, graft survival, and long-term renal function.

    Main Methods:

    • A retrospective analysis of 305 renal autotransplantations performed between 1973 and 1985 in 274 patients.
    • Procedures were indicated for various conditions, including renovascular disease, nephrolithiasis, renal tumors, and ureteral injuries.

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    Main Results:

    • The overall postoperative mortality rate was 4%, associated with advanced age and impaired renal function.
    • Graft loss occurred in 3.6% of cases due to vascular thrombosis or other complications.
    • Long-term renal function remained stable in the majority of patients, with only a small percentage experiencing deterioration.

    Conclusions:

    • Renal autotransplantation with extracorporeal repair is a viable and effective surgical option for carefully selected patients with challenging renal lesions.
    • The procedure offers a favorable risk-benefit profile, preserving renal function and improving patient outcomes.