title: Renal autotransplantation for managing a short upper ureter or after ex vivo complex renovascular reconstruction.
abstract: OBJECTIVE
  To report our contemporary experience with renal autotransplantation (AT), an established treatment for managing patients with a shortened ureter or renovascular disease, as despite its historical importance, AT remains an underused technique by urologists.
  
  
  METHODS
  All patients undergoing AT between 1997 and 2002 for a short ureter after ureteric injury and for renovascular disease were assessed by creatinine level and blood pressure before and after surgery, and antihypertensive drug use and complications.
  
  
  RESULTS
  Eleven patients had AT for renovascular disease and four for ureteric injury. There was no statistical difference in creatinine levels or blood pressure before and after surgery in either group. Eight patients treated with AT for renovascular disease required less antihypertensive medication after surgery. Minor complications occurred in both groups and included a suture abscess, chronic wound pain, and transient acute tubular necrosis. One patient in the ureteric injury group required a transplant nephrectomy after renal vein thrombosis, and one in the renovascular group died from multi-organ system failure.
  
  
  CONCLUSIONS
  AT remains a treatment option for patients with a short ureter after ureteric injury and in those with renovascular disease. Patients had stable renal function and blood pressure after surgery. Most patients treated for renovascular disease required less medication after AT. The procedure is associated with both minor and major complications, which must be considered before surgery.
authors.affiliation: Division of Urology, Department of Interdisciplinary Oncology and Surgery, University of South Florida, Tampa, USA. jwebster@hsc.usf.edu
authors.forename: J Christopher
authors.initials: JC
authors.lastname: Webster
authors.forename: Jason
authors.initials: J
authors.lastname: Lemoine
authors.forename: John
authors.initials: J
authors.lastname: Seigne
authors.forename: Jorge
authors.initials: J
authors.lastname: Lockhart
authors.forename: Victor
authors.initials: V
authors.lastname: Bowers
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000601:surgery; D007431:Intraoperative Complications / Q000601:surgery; D007668:Kidney / Q000601:surgery*; D007674:Kidney Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000601:surgery; D012092:Replantation; D014182:Transplantation, Autologous; D014513:Ureter / Q000293:injuries* / Q000601:surgery