title: Renal autotransplantation--a possibility in the treatment of complex renal vascular diseases and ureteric injuries.
abstract: BACKGROUND
  We report our contemporary experiences with renal autotransplantation in patients with complicated renal vascular diseases and/or complex ureteral injuries. Since its first performance, renal autotransplantation has been steadily improved and become a safe and effective procedure.
  
  
  METHODS
  Between 1998 and 2006, 6 renal autotransplantations in 6 patients were performed at the University Medical Center of Leipzig. After nephrectomy and renal perfusion ex vivo, the kidney was implanted standardized in the fossa iliaca. The vessels were anastomized to the iliac vessels, the ureter was reimplanted in an extravesical tunneled ureteroneocystostomy technique according to Lich-Gregoir. Demographic, clinical, and laboratory data of the patients were collected and analyzed for pre-, intra-, and postoperative period.
  
  
  RESULTS
  Indications for renal autotransplantation were complex renovascular diseases in 2 patients (1 with fibromuscular dysplasia and 1 with Takayasu's arteritis) and in 4 patients with complex ureteral injuries. The median duration of follow-up was 9.7 years (range: 5.6-13.3). The laboratory values of our 6 patients showed improvements of creatinine, urea and blood pressure levels in comparison to the preoperative status at the end of follow-up period.
  
  
  CONCLUSIONS
  The present study reports excellent results of renal autotransplantation in patients with renovascular disease or complex ureteric injuries. After a median follow-up of 9.7 years all 6 patients present with stable renal function as well as normal blood pressure values. Postoperative complications were observed with a rate comparable to other studies.
authors.affiliation: Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Liebigstrasse 20, Leipzig, Germany.
authors.forename: Hans Michael
authors.initials: HM
authors.lastname: Hau
authors.forename: Michael
authors.initials: M
authors.lastname: Bartels
authors.forename: Hans-Michael
authors.initials: HM
authors.lastname: Tautenhahn
authors.forename: Mehmet Haluk
authors.initials: MH
authors.lastname: Morgul
authors.forename: Peter
authors.initials: P
authors.lastname: Fellmer
authors.forename: Phuc
authors.initials: P
authors.lastname: Ho-Thi
authors.forename: Christoph
authors.initials: C
authors.lastname: Benckert
authors.forename: Dirk
authors.initials: D
authors.lastname: Uhlmann
authors.forename: Michael
authors.initials: M
authors.lastname: Moche
authors.forename: Armin
authors.initials: A
authors.lastname: Thelen
authors.forename: Moritz
authors.initials: M
authors.lastname: Schmelzle
authors.forename: Sven
authors.initials: S
authors.lastname: Jonas
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005352:Fibromuscular Dysplasia / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011183:Postoperative Complications / Q000453:epidemiology; D020127:Recovery of Function; D013625:Takayasu Arteritis / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014513:Ureter / Q000293:injuries* / Q000601:surgery