Clinical Application of Renal Autotransplantation in Renovascular and Urologic Disease: 21 Cases

Kim, Tae Hyun; Pack, Kwan Tae; Kim, Young Hoon; Kim, Song Chul; Han, Duck Jong; Kwon, Tae Won

Abstract

BACKGROUND
Renal autotransplantation is a kidney preserving procedure in various clinical situations otherwise requiring nephrectomy or renovascular disease that can not be treated by intervention. The purpose of this study is to report our experiences of renal autotransplantation.
METHODS
A total 21 patients, 9 male and 12 females, underwent renal autotransplantation from May 1995 to July 2008 at our institution and were reviewed retrospectively by medical records.
RESULTS
The mean age of the patients was 46.9 years (21~63). The indications for renal autotransplantation were 6 cases of renal artery aneurysms (28.5%) including 1 renal allograft aneurysm, 6 ureteral obstructions (28.5%), 4 renovascular hypertensions (19%), 2 renal cell carcinomas (9.5%), 2 ureteral cancers (9.5%) and others. The mean operative time was 409.2 minutes (145~689) and mean cold ischemic time was 85.4 min (11~215 min). Renal artery was anastomosed to internal iliac artery in 81% and to external iliac artery in 19%. All kidneys were preserved successfully after removal of lesions and renal artery reconstruction. There were no differences in pre- and post- operative creatinine levels and creatinine clearance. The mean follow up duration was 2.1 years (0.1~11.3) and 1 patient died from the recurrence of ureteral cancer 9 months after operation.
CONCLUSIONS
With the advance of micro-surgical technique and standardization of kidney transplantation technique, possibility of renal preservation with renal autotransplantation has increased more than before. Therefore, renal autotransplantation should be considered as one of the treatment options and performed in appropriately selected patients.