title: Renal Autotransplantation at Three Academic Institutions in Turkey.
abstract: OBJECTIVE
  The objective of this study is to present the experience of 3 institutions performing renal autotransplantation (RAT) and to discuss surgical techniques employed and the results in the light of the medical literature.
  
  
  METHODS
  A total of 14 patients (11 male and 3 female) with a mean age of 47 ± 8 years (35-61 years), who underwent RAT procedure at 3 different institutions between October 2006 and November 2014, in Turkey, were evaluated retrospectively. Indications for RAT procedure are ureteral avulsion, renal artery aneurysm and intimal dissection caused by percutaneous transluminal renal artery angioplasty (PTRA). Twelve patients with ureteral avulsion, 1 patient with renal artery aneurysm and 1 patient with intimal dissection caused by PTRA were followed-up for 103 months. Seven (50%) open and 7 (50%) laparoscopic nephrectomies were performed. Nine patients (64.3%) were right-sided and 5 patients (35.7%) were left-sided. Complications of grade III and above as per Clavien-Dindo classification were assessed.
  
  
  RESULTS
  Mean time from injury to RAT was 21.2 ± 40.1 days. However, 5 (35.7%) patients were treated on the same day of the injury. As per Clavien-Dindo classification, 2 (14.2%) grade IVa and 1 (7.1%) grade IIIa complications were reported. However, no significant correlation was observed between the complications and graft loss regarding type and side of the nephrectomy performed (p = 0.462 and p = 0.505, respectively) and timing of the intervention (p = 0.692).
  
  
  CONCLUSIONS
  RAT is a safe procedure in combination with minimally invasive laparoscopic technique in carefully selected patients; however, it requires expertise and proficiency in laparoscopy, reconstructive urology and transplantation. Nevertheless RAT should be considered as the last resort, when other modalities fail.
authors: Department of Urology, Ondokuz Mayis University, School of Medicine, Samsun, Turkey.
authors: Yarkin Kamil
authors: YK
authors: Yakupoglu
authors: Fazil Tuncay
authors: FT
authors: Aki
authors: Yakup
authors: Y
authors: Kordan
authors: Ender
authors: E
authors: Ozden
authors: Senol
authors: S
authors: Tonyali
authors: Yakup
authors: Y
authors: Bostanci
authors: Hakan
authors: H
authors: Vuruskan
authors: Cenk Yucel
authors: CY
authors: Bilen
authors: Saban
authors: S
authors: Sarikaya
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D014421:Turkey