Kidney autotransplantation: long-term outcomes and complications. Experience in a tertiary hospital and literature review
| Autor: | Mercedes Ruiz, Alvaro-Amancio Fernández, F.J. Burgos, Victoria Gómez, Vital Hevia, Jose-Javier Fabuel |
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| Rok vydání: | 2017 |
| Předmět: |
Nephrology
Adult medicine.medical_specialty Time Factors Urology medicine.medical_treatment 030232 urology & nephrology Constriction Pathologic Transplantation Autologous Arteriovenous Malformations Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine Postoperative Complications Internal medicine Medicine Humans Laparoscopy Retrospective Studies Kidney medicine.diagnostic_test business.industry General surgery Graft Survival Retrospective cohort study Length of Stay Middle Aged Kidney Transplantation Autotransplantation Nephrectomy Surgery Transplantation medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Replantation Ureteral Stricture Ureter business |
| Zdroj: | International urology and nephrology. 49(11) |
| ISSN: | 1573-2584 |
| Popis: | To analyze indications, surgical technique, complications and long-term outcomes of kidney autotransplantation (KAT) after 26-year experience at a single institution. 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.” 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. 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. |
| Databáze: | OpenAIRE |
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