MP29-08 PERCUTANEOUS RENAL HILAR BLOCKADE TO PREDICT SUCCESS OF AUTO KIDNEY TRANSPLANTATION FOR LOIN PAIN HEMATURIA SYNDROME

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery I1 Apr 2016MP29-08 PERCUTANEOUS RENAL HILAR BLOCKADE TO PREDICT SUCCESS OF AUTO KIDNEY TRANSPLANTATION FOR LOIN PAIN HEMATURIA SYNDROME Jeffrey Campsen, Mitchell Bassett, Ryan O'Hara, Heather Thiesset, Robin Kim, Rulon Hardman, and Blake Hamilton Jeffrey CampsenJeffrey Campsen More articles by this author , Mitchell BassettMitchell Bassett More articles by this author , Ryan O'HaraRyan O'Hara More articles by this author , Heather ThiessetHeather Thiesset More articles by this author , Robin KimRobin Kim More articles by this author , Rulon HardmanRulon Hardman More articles by this author , and Blake HamiltonBlake Hamilton More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1092AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previous reports describe renal auto-transplantation (RAT) as a possible therapy for loin pain hematuria syndrome (LPHS) with reported successful pain relief ranging between 25-65%. We propose that in patients with classic symptoms of LPHS, a response to percutaneous renal hilar blockade (RHB) can help predict when a patient should be referred for RAT. METHODS The procedure of renal hilar block is similar to that of a percutaneous celiac plexus block. Prior to performing the procedure, a pain assessment is performed using a 0-10 numeric pain rating scale. Percutaneous hilar block is performed with the patient in the prone position on the CT gantry. The skin is cleansed using chlorexidine scrub and anesthetized using lidocaine. Using CT guidance, a 21G chiba needle is advanced to the anterior renal hilum. Aspiration is performed to ensure a vessel has not been entered. A solution of 10ml 2.0% lidocaine and 10ml 0.25% Marcaine is injected slowly to infiltrate the hilum. A post-procedure pain assessment is then performed. If their pain score was reduced immediately after the RHB then they were referred for RAT. RESULTS There were 10 RAT preformed at the University of Utah during a 3 year period. Six had LPHS and were enrolled in this study. All patients receiving RHB had relief of pain. Pre-procedure average score was 8/10 with post-procedure score being 0/10. All patients underwent a successful RAT and currently have a functioning graft 6-12 months post- procedure (Table). CONCLUSIONS Successful RAT for LPHS relies on the appropriate diagnosis. In this study all patients had relief of pain after RHB and then were successfully transplanted. RHB should be considered as a tool to define LPHS patients appropriate for RAT. This appears to be a viable method for further study to help predict which patients should be referred for RAT after diagnosis of LPHS. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e382-e383 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Jeffrey Campsen More articles by this author Mitchell Bassett More articles by this author Ryan O'Hara More articles by this author Heather Thiesset More articles by this author Robin Kim More articles by this author Rulon Hardman More articles by this author Blake Hamilton More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...