[Kidney autotransplantation in therapy of complex renovascular diseases. Indications, technic and results]

Fibromuscular dysplasia of the renal artery can be treated by vascular surgical reconstruction or percutaneous transluminal angioplasty. If, however, the secondary and tertiary branches of the renal artery are involved, this lesion cannot be corrected with conventional surgical techniques or invasive radiologic methods. Because the disease often affects young patients, in whom an etiologic treatment of the hypertension is desirable, we have performed ex vivo repair of lesions of the renal artery and its branches with autotransplantation of the kidney in five patients. Four patients had renovascular hypertension and one patient an aneurysm of a tertiary branch of the renal artery. Postoperatively, renal function, as evidenced by renal scan and renal function studies, was normal in all autotransplanted kidneys. All four patients with renovascular hypertension had normal blood pressure postoperatively. Only one patient had to be treated with single drug antihypertensive therapy.