title: Early and late results of ex vivo repair and autotransplantation in solitary kidneys.
abstract: BACKGROUND
  Autotransplantation of a solitary kidney provides an excellent opportunity to study the immediate and long-term consequences of intra-operative renal ischaemia. The purpose of this report is to describe a series of nine patients who underwent ex vivo repair and autotransplantation on solitary kidneys.
  
  
  METHODS
  The series included six females and three males with a mean age of 36 years. Seven of the nine patients were hypertensive (mean number of anti-hypertensive agents: 3). Two patients had chronic renal failure (serum creatinine levels: 192 and 205 μmol l(-1)). All arteries except one with Takayasu disease were affected by dysplastic aneurysm or fibrodysplasia lesion. There was no atherosclerotic lesion. The mean number of renal artery branches repaired was 3.1 per patient. Mean duration of ischaemia was 161 min.
  
  
  RESULTS
  Creatinaemia increased in all patients following the procedure. Creatinaemia and clearance returned to preoperative values between the 3rd and 10th postoperative days. One kidney was lost due to renal vein thrombosis. Late findings indicated that renal function was stable and there was no deterioration in the function of the autotransplanted kidneys after a follow-up period of 89 months. Preoperative versus postoperative creatinaemia and clearance levels were respectively 111 vs. 105 μmol l(-1) and 66.9 vs. 62.0 ml min(-1) (ns). During the same time, the mean number of anti-hypertensive agents decreased slightly from 3 to 2.5.
  
  
  CONCLUSIONS
  In this small series of patients who underwent ex vivo repair and autotransplantation on solitary kidneys, intra-operative renal ischaemia had no detrimental effect on renal function.
authors.affiliation: Cardiovascular Surgery, CHU Saint-Etienne, Avenue Albert Raimond, Saint-Priest en Jarez, France.
authors.forename: J
authors.initials: J
authors.lastname: Morin
authors.forename: B
authors.initials: B
authors.lastname: Chavent
authors.forename: A
authors.initials: A
authors.lastname: Duprey
authors.forename: J N
authors.initials: JN
authors.lastname: Albertini
authors.forename: J P
authors.initials: JP
authors.lastname: Favre
authors.forename: X
authors.initials: X
authors.lastname: Barral
mesh_terms: D000293:Adolescent; D000328:Adult; D000783:Aneurysm / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002648:Child; D050377:Cold Ischemia; D003404:Creatinine / Q000097:blood; D005260:Female; D005602:France; D006801:Humans; D006978:Hypertension, Renovascular / Q000097:blood / Q000503:physiopathology / Q000601:surgery; D007668:Kidney / Q000098:blood supply / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects; D012077:Renal Artery / Q000503:physiopathology / Q000601:surgery*; D012078:Renal Artery Obstruction / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D012092:Replantation / Q000009:adverse effects; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003404:Creatinine