Autotransplantation for Extensive Ureteral Disease

Abstract

Renal autotransplantation has developed in recent years as a logical extension of experience gained in the fields of renal revascularization and transplantation. Although earlier attempts had been made, the first successful renal autotransplant was performed in 1962 by Hardy, who transferred the right kidney into the ipsilateral iliac fossa in a patient whose ureter had been severely damaged by previous aortic surgery and whose contralateral renal function was compromised [6]. Shortly thereafter, Victor Marshall performed a similar procedure in a young woman who had suffered a 12-cm ureteral loss during transperitoneal spinal fusion [11]. The majority of autotransplantation procedures reported since that time have been done for correction of extensive renovascular disease, with isolated reports also submitted for trauma, calculus disease, or renal neoplasia [12]. Surprisingly enough, the use of autotransplantation to salvage kidneys in patients with extensive ureteral disease has so far been relatively infrequent.