Renal Autotransplantation in Lynch Syndrome: A Viable Option in a Patient With Contralateral Metachronous Ureteral Cancer

Abstract

The success of human kidney allotransplantation was realized over six decades ago. First described 50 years ago, renal autotransplantation has been utilized sparingly as a salvage procedure for patients at risk of losing renal function, either from a benign or malignant condition. While classically associated with colorectal malignancies, Lynch syndrome also carries a small yet significant risk for the development of ureteral carcinoma. For these patients who develop chronic kidney disease, allotransplantation may not be an option due to the lifelong risk of several malignancies. We report the first known case of renal autotransplantation in a patient with metachronous ureteral cancer due to Lynch syndrome.

Kidney Auto Transplantation: A Long Forgotten Technique?

“…This counts both for extrinsic lesions, such as with Mb. Ormond, or retroperitoneal tumors [22][23][24], as well as for intrinsic lesions, such as with urothel carcinoma, or long ureteral stenosis [1,12,[25][26][27][28][29]. This means that kidney auto transplantation is, besides the Ileuminterponate, a potent solution for restructuring after complex ureteral injuries with individual kidneys, or limited kidney function combined with a significant loss of the upper and middle third of the ureter [26,30,31].…”