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Ex-vivo renal surgery feasible for complex renal conditions

11 Jan 2018
Surgeons were alleged to have permanently disabled a kidney cancer patient by removing his healthy kidney instead of the affected organ.

It appears that ex-vivo renal surgery may be performed for complex renal pathologies, but it is necessary to carefully select patients to achieve positive outcomes, a recent study suggests.

The investigators examined three patients who underwent ex-vivo renal surgery and autotransplantation for benign and malignant renal conditions. The procedures were performed in the urology and transplant departments between July 2015 and January 2016.

Patient 1 was a 63-year-old man presenting with spontaneous bleed from a renal mass in a solitary functional right kidney. Patient 2 was a 50-year-old man with bilateral renal tumours involving renal veins. Finally, patient 3 was a 50-year-old man with two previous failed right-sided pyeloplasties.

Of the three patients included in the study, none had intraoperative complications. Patient 1 had laparoscopic nephrectomy, ex-vivo partial nephrectomy followed by autotransplantation. No disease recurrence happened after a 6-month follow-up, and renal functions were stable.

Bilateral open radical nephrectomies were carried out in patient 2. Autotransplantation was performed on the right kidney following ex-vivo partial nephrectomy. On the left, a further procedure was cancelled after radical nephrectomy because of extensive disease involvement. The patient became anuric with poor Doppler signals after the procedure.

Following exploration, surgeons suggested complete renal vein obstruction with infarction of the autotransplanted right kidney requiring nephrectomy. There was disease recurrence found at the native renal bed at 6 months’ follow-up.

Finally, patient 3 underwent laparoscopic nephrectomy, ex-vivo pyeloplasty and autotransplantation. The patient was asymptomatic with stable renal functions at 12 months’ follow-up.

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Most Read Articles
Pearl Toh, 5 days ago
A study finds no evidence that using pharmaceutical aids alone for smoking cessation helps improve the chances of successful quitting despite promising results in previous randomized trials and routine prescription of such drugs to help quit smoking.
Elvira Manzano, 2 days ago
Cancer patients at risk for recurrent venous thromboembolism (VTE) are less likely to experience recurrence with rivaroxaban compared with dalteparin, the Select-D trial has shown, ushering in a new standard of care (SoC) for cancer-related VTE.
6 days ago

It appears that patients with rheumatoid arthritis (RA) are at an increased risk of obstructive sleep apnoea (OSA) secondary to both traditional and RA-related risk factors, a recent study has found.

Yesterday
Weight loss medications that have received the Food and Drug Administration (FDA) approval appear to confer only modest positive benefits for cardiometabolic risk profile, according to a study.