Introduction and Objectives. Renal autotransplantation is a kidney-saving surgical procedure used in selected patients. The\npurpose of this report is to review nine typical and atypical indications for kidney autotransplantation and evaluate its effectiveness\nin maintaining kidney function and avoiding cancer recurrence. Materials and Methods. From 1999 till 2014, nine renal\nautotransplantations were performed in our center. A retrospective case review was done. Four of nine patients had a solitary\nfunctioning kidney. Typical indications for autotransplantation included extended ureteric disease in 5 patients, intrasinusal\ntumor on a solitary kidney in 1 patient, and renal artery aneurysm in 1 patient. Atypical indications consisted in bilateral urothelial\ntumors in 1 patient and interrupted live kidney transplantation in 1 patient. Mean cold ischemia time was 209 minutes. Demographic\nfactors, indications, renal function before and after surgery, and in the long term, cancer recurrence and disease-free\nsurvival were evaluated. Results. Renal function was maintained in 8 patients during the early follow-up. No serious complications\noccurred in the postoperative period. Median duration of follow-up was 50 months. In 4 patients with a normal contralateral\nkidney, mean preoperative and at discharge creatinine clearance were 105.45 ml/min and 121.02 ml/min, respectively. Although\nvalues showed an improvement in the kidney function, the difference was not significant (p value 0.3). In the other 4 patients with\na solitary kidney, mean discharge creatinine clearance was 99.24 ml/min surprisingly higher than the preoperative value\n96.92 ml/min. At the last follow-up, kidney function was preserved for the two groups (normal contralateral kidney/solitary\nkidney) with relatively stable creatinine clearance values: 108.45 ml/min and 85.9 ml/min, respectively. No patients required\nsecondary dialysis. Conclusion. Renal autotransplantation is a rare, safe, and effective surgical procedure for the treatment of\ncomplex urologic conditions. In some instances, it may be of great utility for kidney salvage in some carefully selected patients.
Loading....