title: Clinical and safety outcomes of laparoscopic nephrectomy with renal autotransplantation for the loin pain-hematuria syndrome: a 14-year longitudinal cohort study.
abstract: OBJECTIVE
  The objective of this study is to assess clinical and safety outcomes after laparoscopic nephrectomy with autotransplantation for loin pain-hematuria syndrome (LPHS).
  
  
  METHODS
  We conducted telephone interviews using structured questionnaires and retrospectively reviewed data on all patients who underwent laparoscopic nephrectomy with autotransplantation for LPHS between January 2000 and May 2014.
  
  
  RESULTS
  A total of 24 laparoscopic nephrectomies with renal autotransplantation of 21 patients with LPHS were reviewed. Eighty-three per cent were female with a mean age of 31 years. Postoperatively, graft loss resulting in subsequent nephrectomy occurred in two patients; However, no patients died (median follow-up = 22 months, range 5 to 78 months) or required dialysis (median follow-up = 10 months, range 0.2 to 178 months). There was no significant difference in estimated glomerular filtration rate (eGFR) before and after surgery (100 ± 22 vs. 97 ± 23 mL/min/1.73 m2; P = 0.37). Among 14 patients (16 autotransplantation) with telephone follow-up, 14 (88%) resulted in pain relief and no operation resulted in worsening pain. All procedures resulted in immediate pain relief; pain recurrence was reported after two procedures. However, those patients had pain-free period up to 36 months. The quality of life was better after 15 (94%) autotransplantation with higher employment rate (44% vs. 69%; P = 0.04). Two patients with graft loss reported better pain control and quality of life.
  
  
  CONCLUSIONS
  Renal autotransplantation is a possible treatment option for LPHS refractory to conservative medical treatment. It can offer pain relief and better quality of life. Despite postoperative risk, it seems to be safe for survival and renal outcomes.
authors.affiliation: Division of Transplantation Surgery, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Adeel S
authors.initials: AS
authors.lastname: Zubair
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: Wisit
authors.initials: W
authors.lastname: Cheungpasitporn
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Erickson
authors.affiliation: Division of Transplantation Surgery, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Mikel
authors.initials: M
authors.lastname: Prieto
keywords: loin pain-hematuria syndrome; outcome; renal autotransplantation; safety; transplantation