Renal autotransplantation using hypothermic storage and pulsatile perfusion.
Three patients with severe hypertension secondary to renal artery stenosis were treated by renal autotransplantation. Of these 3 patients 2 had solitary kidneys and 1 had 2 renal arteries to each kidney, all of which were stenosed. Renal autotransplantation with hypothermia of the kidney was performed in all 3 patients rather than the more conventional arterial bypass or endarterectomy because 1) hypothermic preservation permitted a prolonged ischemia time and 2) there was improved exposure for the vascular anastomosis. Postoperatively 2 patients remained normotensive without drugs for 9 and 12 months and 1 patient died of septicemia not directly related to the autotransplant. All 3 patients required expansion of the intravascular volume postoperatively to overcome the loss of vasoconstrictor substances following restoration of renal blood flow.
D001027:Aortography; D001157:Arterial Occlusive Diseases / Q000150:complications; D001158:Arteries; D001794:Blood Pressure / Q000187:drug effects; D004232:Diuretics / Q000494:pharmacology; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000150:complications; D007008:Hypokalemia / Q000139:chemically induced; D007036:Hypothermia, Induced; D007668:Kidney / Q000098:blood supply; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000601:surgery; D012083:Renin / Q000097:blood / Q000494:pharmacology; D013997:Time Factors; D014182:Transplantation, Autologous; D014513:Ureter / Q000637:transplantation; D014656:Vascular Surgical Procedures; D014680:Veins
D004232:Diuretics; D012083:Renin