Recurrent graft pain following renal autotransplantation for loin pain haematuria syndrome.
OBJECTIVE
To review retrospectively the Perth experience of autotransplantation for loin pain haematuria syndrome and identify possible factors associated with its failure.


METHODS
The medical records of 11 women patients (median age 42 years, range 29-48) who had 12 autotransplantations were reviewed. All patients were then interviewed and asked whether they considered the operation a success.


RESULTS
All patients initially had complete relief of symptoms. Three patients who had four transplants are still symptom-free with a follow-up of 24-46 months. Five patients have had partial relief with marked variability in their patterns of recurrent pain. Three patient have symptoms as severe as those before operation. One kidney was lost because of acute thrombosis and another developed a urinoma. No patient had deterioration in renal function.


CONCLUSIONS
Renal autotransplantation is a treatment option of last resort, with acceptable morbidity in patients with intractable, functionally disabling renal pain, but three-quarters of these patients may develop recurrent pain in the transplant site. A current or past history of depression or absence of haematuria may represent risk factors for a poor post-operative prognosis. Treatment failure is predictable by a poor response to sympathetic neurolytic block.
Parnham
A P
AP
Department of Nephrology, Royal Perth Hospital, Australia.
Low
A
A
Finch
P
P
Perlman
D
D
Thomas
M A
MA
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006417:Hematuria / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007674:Kidney Diseases / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D013577:Syndrome; D014182:Transplantation, Autologous / Q000009:adverse effects; D017211:Treatment Failure