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Kidney Autotransplantation and Orthotopic Kidney Transplantation: Two Different Approaches for Complex Cases

INTRODUCTION: Transplantation surgery teams often have to face complex cases. In certain circumstances, such as occlusion of the iliac vessels or prior pelvic surgery, heterotopic kidney transplantation may not be feasible and orthotopic kidney transplantation (OKT) could be a good alternative. Kidn...

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Autores principales: Artiles Medina, Alberto, Gómez Dos Santos, Victoria, Díez Nicolás, Víctor, Hevia Palacios, Vital, Ruiz Hernández, Mercedes, Laso García, Inés, Mata Alcaraz, Marina, Galeano Álvarez, Cristina, Jiménez Cidre, Miguel Ángel, Arias Fúnez, Fernando, Fernández Lucas, Milagros, Burgos Revilla, Francisco Javier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9366201/
https://www.ncbi.nlm.nih.gov/pubmed/35968202
http://dx.doi.org/10.1155/2022/9299397
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author Artiles Medina, Alberto
Gómez Dos Santos, Victoria
Díez Nicolás, Víctor
Hevia Palacios, Vital
Ruiz Hernández, Mercedes
Laso García, Inés
Mata Alcaraz, Marina
Galeano Álvarez, Cristina
Jiménez Cidre, Miguel Ángel
Arias Fúnez, Fernando
Fernández Lucas, Milagros
Burgos Revilla, Francisco Javier
author_facet Artiles Medina, Alberto
Gómez Dos Santos, Victoria
Díez Nicolás, Víctor
Hevia Palacios, Vital
Ruiz Hernández, Mercedes
Laso García, Inés
Mata Alcaraz, Marina
Galeano Álvarez, Cristina
Jiménez Cidre, Miguel Ángel
Arias Fúnez, Fernando
Fernández Lucas, Milagros
Burgos Revilla, Francisco Javier
author_sort Artiles Medina, Alberto
collection PubMed
description INTRODUCTION: Transplantation surgery teams often have to face complex cases. In certain circumstances, such as occlusion of the iliac vessels or prior pelvic surgery, heterotopic kidney transplantation may not be feasible and orthotopic kidney transplantation (OKT) could be a good alternative. Kidney autotransplantation (KAT) has been described as a potential treatment for complex renovascular, ureteral, or neoplastic conditions. There are scarce data regarding the complications and outcomes of these procedures; therefore, we present our experience. MATERIALS AND METHODS: We retrospectively analysed the medical records of both 21 patients who had received OKT and 19 patients who underwent KAT between 1993 and 2020. We collected demographic features and data regarding surgical technique, complications, and graft outcomes. Kidney graft survival was calculated using Kaplan–Meier survival analysis. RESULTS: Regarding OKT, in 15 (71.43%) cases, it was the first kidney transplantation. The most common indication was the unsuitable iliac region due to vascular abnormalities (57.14%). The early postoperative complication rate was high (66.67%), with 23.81% of Clavien grade 3b complications. During the follow-up period (mean 5.76 -SD 6.15- years), we detected 9 (42.85%) graft losses. At 1 year, the survival rate was 84.9%. Concerning KAT, the most frequent indication was ureteral pathology (52.63%), followed by vascular lesions (42.11%). The overall early complication rate was 42.11%. During the follow-up period (mean of 4.47 years), 4 (15.79%) graft losses were reported. CONCLUSIONS: Although OKT and KAT have high complication rates, these techniques can be considered as two valuable approaches for complex cases, in the absence of other therapeutic options.
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spelling pubmed-93662012022-08-12 Kidney Autotransplantation and Orthotopic Kidney Transplantation: Two Different Approaches for Complex Cases Artiles Medina, Alberto Gómez Dos Santos, Victoria Díez Nicolás, Víctor Hevia Palacios, Vital Ruiz Hernández, Mercedes Laso García, Inés Mata Alcaraz, Marina Galeano Álvarez, Cristina Jiménez Cidre, Miguel Ángel Arias Fúnez, Fernando Fernández Lucas, Milagros Burgos Revilla, Francisco Javier Adv Urol Research Article INTRODUCTION: Transplantation surgery teams often have to face complex cases. In certain circumstances, such as occlusion of the iliac vessels or prior pelvic surgery, heterotopic kidney transplantation may not be feasible and orthotopic kidney transplantation (OKT) could be a good alternative. Kidney autotransplantation (KAT) has been described as a potential treatment for complex renovascular, ureteral, or neoplastic conditions. There are scarce data regarding the complications and outcomes of these procedures; therefore, we present our experience. MATERIALS AND METHODS: We retrospectively analysed the medical records of both 21 patients who had received OKT and 19 patients who underwent KAT between 1993 and 2020. We collected demographic features and data regarding surgical technique, complications, and graft outcomes. Kidney graft survival was calculated using Kaplan–Meier survival analysis. RESULTS: Regarding OKT, in 15 (71.43%) cases, it was the first kidney transplantation. The most common indication was the unsuitable iliac region due to vascular abnormalities (57.14%). The early postoperative complication rate was high (66.67%), with 23.81% of Clavien grade 3b complications. During the follow-up period (mean 5.76 -SD 6.15- years), we detected 9 (42.85%) graft losses. At 1 year, the survival rate was 84.9%. Concerning KAT, the most frequent indication was ureteral pathology (52.63%), followed by vascular lesions (42.11%). The overall early complication rate was 42.11%. During the follow-up period (mean of 4.47 years), 4 (15.79%) graft losses were reported. CONCLUSIONS: Although OKT and KAT have high complication rates, these techniques can be considered as two valuable approaches for complex cases, in the absence of other therapeutic options. Hindawi 2022-08-03 /pmc/articles/PMC9366201/ /pubmed/35968202 http://dx.doi.org/10.1155/2022/9299397 Text en Copyright © 2022 Alberto Artiles Medina et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Artiles Medina, Alberto
Gómez Dos Santos, Victoria
Díez Nicolás, Víctor
Hevia Palacios, Vital
Ruiz Hernández, Mercedes
Laso García, Inés
Mata Alcaraz, Marina
Galeano Álvarez, Cristina
Jiménez Cidre, Miguel Ángel
Arias Fúnez, Fernando
Fernández Lucas, Milagros
Burgos Revilla, Francisco Javier
Kidney Autotransplantation and Orthotopic Kidney Transplantation: Two Different Approaches for Complex Cases
title Kidney Autotransplantation and Orthotopic Kidney Transplantation: Two Different Approaches for Complex Cases
title_full Kidney Autotransplantation and Orthotopic Kidney Transplantation: Two Different Approaches for Complex Cases
title_fullStr Kidney Autotransplantation and Orthotopic Kidney Transplantation: Two Different Approaches for Complex Cases
title_full_unstemmed Kidney Autotransplantation and Orthotopic Kidney Transplantation: Two Different Approaches for Complex Cases
title_short Kidney Autotransplantation and Orthotopic Kidney Transplantation: Two Different Approaches for Complex Cases
title_sort kidney autotransplantation and orthotopic kidney transplantation: two different approaches for complex cases
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9366201/
https://www.ncbi.nlm.nih.gov/pubmed/35968202
http://dx.doi.org/10.1155/2022/9299397
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