Vol.:(0123456789) 1 3 Int Urol Nephrol DOI 10.1007/s11255-017-1680-1 UROLOGY - ORIGINAL PAPER Kidney autotransplantation: long‑term outcomes and complications. Experience in a tertiary hospital and literature review Mercedes Ruiz 1  · Vital Hevia 1  · Jose‑Javier Fabuel 1  · Alvaro‑Amancio Fernández 1  · Victoria Gómez 1  · Francisco‑Javier Burgos 1   Received: 27 June 2017 / Accepted: 14 August 2017 © Springer Science+Business Media B.V. 2017 was performed through laparoscopy in 2 cases (13.3%) and open in 13 (86.7%). Vascular grafts to reperfuse the kidney were used in 8 patients, and ureteral reimplantation was per- formed in 11 cases. Mean hospital stay was 9.1 days (range 3–20). Seven patients (46.7%) developed postoperative complications: 6 minor (Clavien I–II) and 1 major (Clavien III). After a mean follow-up of 73.1 months (range 7–312), 80% of the patients have a functioning graft. Most common indication reported in the literature is ureteral stricture, espe- cially in the most recent years. Graft survival is variable, and complications are frequent, but usually minor. Conclusions KAT is an efective treatment for complex ureteral lesions and kidney vascular abnormalities, with good results in the long term. Surgical complications are fre- quent, but usually minor. As a challenging surgery, it should be performed by experienced kidney transplant surgeons. Complex and proximal ureteral injuries are nowadays the main indication of this procedure. Keywords Kidney autotransplantation · Renal autotransplant · Ureteral stricture · Kidney vascular abnormalities · Transplantation Introduction Kidney autotransplantation (KAT) is an infrequent proce- dure in urology. It has been performed as an alternative of treatment for complex renovascular lesions, complex ure- teral strictures and nephron-sparing surgery in complex renal tumors and in chronic loin pain syndrome [1–4]. Although vascular injuries are still a major indication for this technique, the number of KAT performed due to this condition has decreased mainly because of endovascular improvements in the last decades. Therefore, at present, the Abstract Objective To analyze indications, surgical technique, com- plications and long-term outcomes of kidney autotransplan- tation (KAT) after 26-year experience at a single institution. Materials and methods A retrospective observational study of patients who underwent KAT at our institution (Janu- ary 1990–December 2016) was carried out. Data collected included indications, surgical technique, complications (Clavien–Dindo), hospital stay and long-term outcomes. Literature review was performed through MEDLINE and ClinicalKey databases including “kidney,” “renal,” “autotransplantation” and “autograft.” Results Fifteen patients underwent a KAT, with a mean age of 41 years (range 34–59). Indications were vascular abnor- malities in 8 cases and ureteral injury in 7. Nephrectomy Electronic supplementary material The online version of this article (doi:10.1007/s11255-017-1680-1) contains supplementary material, which is available to authorized users. * Vital Hevia vital.hevia.uro@gmail.com Mercedes Ruiz merh06@gmail.com Jose-Javier Fabuel drfabuel@gmail.com Alvaro-Amancio Fernández feraslev@gmail.com Victoria Gómez vgomezd69@gmail.com Francisco-Javier Burgos burgoss2000@yahoo.es 1 Urology Department, Hospital Ramón y Cajal, IRYCIS, Alcalá University, Ctra Colmenar km 9,100, 28034 Madrid, Spain