Renal autotransplantation

Abstract

The Department of Urology in the Lahey Clinic has a considerable reputation in the treatment of renovascular conditions, and this month they have produced a review of renal autotransplantation. This interesting, if infrequently used, surgical technique is potentially useful to urologists in several different situations. Intermittent androgen suppression was introduced based on solid laboratory evidence, and has been accepted by many as a way of treating advanced prostate cancer. The authors from Vancouver, from the department where it was introduced, present a review on its use. Laser prostatectomy has gone through interesting developments since it was introduced some years ago. Many techniques and types of laser have come and gone, after initial excitement, but some have lasted the course. The author from New York, who has extensive experience in this area, has written an interesting review on the subject. The work of the Department of Urology in Bern relating to ileal orthotopic bladder substitution is well known, and their technique has been presented in last month's Surgery Illustrated Section in this Journal. Here they present a review of the postoperative management of such patients.

Kidney Auto Transplantation: A Long Forgotten Technique?

“…Since the first kidney auto transplantation 1963 by J. D. Hardy [1] this method has established itself as a tested alternative procedure for patients with complex ureteral lesions or vascular and Reno vascular disorders [1][2][3]25]. Since this time, cases and studies which report good long term results with a selected group of patients have been published regularly.…”

“…Since this time, cases and studies which report good long term results with a selected group of patients have been published regularly. These patients usually suffer from long ureteral lesions, metabolic stone disorders, complex vascular and Reno vascular disorders and diverse malignoma [2][3][4][5][6]12,14,26,27]. In the care of experienced transplantation surgeons, kidney auto transplantation is a safe and efficient procedure to treat the above mentioned disorders.…”

“…In publications, there are repeated reports of good long-term results after auto transplantation regarding the kidney's function and the interval without tumors with patients with bilateral kidney carcinoma or a kidney cell carcinoma in individual kidneys [3,[12][13][14]. The largest publication in this scope is by Mickisch [14].…”

“…But these indications are also seen controversially from an oncological point of view and the indication should be rigorously evaluated [3,12].…”

“…As time went by, it became obvious that kidney auto transplantation is a safe and effective method to treat the most diverse disorders that would otherwise lead to a loss of the kidney's function. Among these are a multitude of complex disorders, such as iatrogenic injuries of the ureter, lithiasis, kidney pain syndrome, autoimmune deficiencies, such as retroperitoneal fibrosis, or renovascular disorders, such as stenosis of the distal kidney arteries, intrarenal aneurysms, arteriovenous deformities, and significant multivascular disorders [2][3][4].…”