A Nationwide Analysis of Kidney Autotransplantation

Abstract

There are limited data regarding outcomes of patients underwent kidney autotransplantation. This study aims to investigate outcomes of such patients. The nationwide inpatient sample database was used to identify patients underwent kidney autotransplantation during 2002 to 2012. Multivariate analyses using logistic regression were performed to investigate morbidity predictors. A total of 817 patients underwent kidney autotransplantation from 2002 to 2012. The most common indication of surgery was renal artery pathology (22.7%) followed by ureter pathology (17%). Overall, 97.7 per cent of operations were performed in urban teaching hospitals. The number of procedures from 2008 to 2012 were significantly higher compared with the number of them from 2002 to 2007 (473 vs 345, P < 0.01). The overall mortality and morbidity of patients were 1.3 and 46.2 per cent, respectively. The most common postoperative complications were transplanted kidney failure (10.7%) followed by hemorrhagic complications (9.7%). Obesity [adjusted odds ratio (AOR): 9.62, P < 0.01], fluid and electrolyte disorders (AOR: 3.67, P < 0.01), and preoperative chronic kidney disease (AOR: 1.80, P = 0.03) were predictors of morbidity in patients. In conclusion, Kidney autotransplantation is associated with low mortality but a high morbidity rate. The most common indications of kidney autotransplantation are renal artery and ureter pathologies, respectively. A kidney transplant failure rate of 10.7 per cent was observed in patients with kidney autotransplantation. The most common postoperative complication was hemorrhagic in nature.

Backtable ureteroscopy for retrieval of retained stent or stone: A novel technique in renal autotransplant

“…Renal autotransplantation is a well described procedure for treatment of renal artery stenosis, renal artery aneurysm, and high ureteral injuries. 5 While not first line therapy, renal autotransplantation is a safe and effective treatment modality for carefully selected patients with LPHS non-responsive to less invasive therapies. 1 Renal autotransplant has been shown to provide long term pain relief for 70–100% of patients with LPHS, with follow-up extending to 8 years and beyond.…”

Open ureteroplasty with buccal mucosa graft for long proximal strictures: A good option for a rare problem

“…Even though buccal mucosa harvesting is well established and straightforward current guidelines still do not recommend BMG ureteroplasty as an equal alternative to more invasive alternatives such as ileum interposition or renal auto-transplantation [3][4][5][6].…”

Rekonstruktive Chirurgie des Ureters

“…Die Datenlage in der Literatur zu langfristigen Therapieergebnissen ist sehr limitiert. In einer kürzlich publizierten nationalen Multizenterstudie wurden 817 Patienten evaluiert, die in den Jahren 2002 bis 2012 eine renale Autotransplantation erhielten [28]. In 17 % der Fälle wurde die Autotransplantation aufgrund einer Ureterpathologie durchgeführt.…”