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Kidney autotransplantation: long-term outcomes and complications. Experience in a tertiary hospital and literature review.

Abstract：

OBJECTIVE:To analyze indications, surgical technique, complications and long-term outcomes of kidney autotransplantation (KAT) after 26-year experience at a single institution. MATERIALS AND METHODS:A retrospective observational study of patients who underwent KAT at our institution (January 1990-December 2016) was carried out. Data collected included indications, surgical technique, complications (Clavien-Dindo), hospital stay and long-term outcomes. Literature review was performed through MEDLINE and ClinicalKey databases including "kidney," "renal," "autotransplantation" and "autograft." RESULTS:Fifteen patients underwent a KAT, with a mean age of 41 years (range 34-59). Indications were vascular abnormalities in 8 cases and ureteral injury in 7. Nephrectomy was performed through laparoscopy in 2 cases (13.3%) and open in 13 (86.7%). Vascular grafts to reperfuse the kidney were used in 8 patients, and ureteral reimplantation was performed in 11 cases. Mean hospital stay was 9.1 days (range 3-20). Seven patients (46.7%) developed postoperative complications: 6 minor (Clavien I-II) and 1 major (Clavien III). After a mean follow-up of 73.1 months (range 7-312), 80% of the patients have a functioning graft. Most common indication reported in the literature is ureteral stricture, especially in the most recent years. Graft survival is variable, and complications are frequent, but usually minor. CONCLUSIONS:KAT is an effective treatment for complex ureteral lesions and kidney vascular abnormalities, with good results in the long term. Surgical complications are frequent, but usually minor. As a challenging surgery, it should be performed by experienced kidney transplant surgeons. Complex and proximal ureteral injuries are nowadays the main indication of this procedure.

journal_name

Int Urol Nephrol

journal_title

International urology and nephrology

authors

Ruiz M,Hevia V,Fabuel JJ,Fernández AA,Gómez V,Burgos FJ

doi

10.1007/s11255-017-1680-1

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

1929-1935

issue

eissn

0301-1623

issn

1573-2584

pii

10.1007/s11255-017-1680-1

journal_volume

pub_type

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Kidney autotransplantation: long-term outcomes and complications. Experience in a tertiary hospital and literature review.