[Renal autotransplantation and extra-corporeal surgery]

Area of Science:

• Urology
• Nephrology
• Vascular Surgery

Context:

• Renal autotransplantation involves surgically moving a kidney to a new location within the body.
• This procedure was historically performed for complex renal pathologies, including obstructive uropathy, renovascular hypertension, and renal masses.
• The study retrospectively analyzes outcomes from a significant patient cohort over a defined period.

Purpose:

• To evaluate the efficacy and safety of renal autotransplantation in a diverse patient population.
• To assess the surgical outcomes for specific conditions such as obstructive disease, renovascular hypertension, renal calculi, and renal cell carcinoma.
• To identify and analyze complications associated with renal autotransplantation.

Summary:

• A total of 53 patients underwent renal autotransplantation between 1975 and 1987 for various renal diseases.
• The study reported a low mortality rate (3/53) due to complications like bleeding and sepsis, with specific complications noted for arterial anastomosis rupture and wound infection.
• Successful outcomes were observed in patients with obstructive uropathy (23/24), renovascular hypertension (5/5), renal calculi (10/12), and renal cell carcinoma (3/3).
• Arterial reconstruction for aneurysms was successful in 3 out of 5 patients, and other vascular conditions like arteriovenous fistula and nut cracker syndrome were managed effectively.

Impact:

• Renal autotransplantation demonstrates significant success in resolving obstructive uropathy and normalizing blood pressure in hypertensive patients.
• The procedure is effective in managing complex renal calculous disease and treating renal cell carcinoma, even in patients with solitary kidneys.
• While complications such as arterial thrombosis and sepsis can occur, the overall success rate highlights the procedure's value in selected cases.