Abstract
The Use Ex-Vivo Renal Autotransplantation to Treat Hypertension Secondary to Renal Artery Disease: Two Case Reports
Highlights
Renal autotransplantation (RAT) is a relatively well-documented practice
The current protocol dictates that Percutaneous Transluminal Angioplasty (PCA) is the optimal treatment method for renal artery stenosis, in isolated occlusive lesions with arteriosclerotic aetiology or myofiber dysplastic lesions
Several studies have sought to determine the extent of vascular injury required to illicit hypertension, requiring subsequent invasive treatment. They have further demonstrated the absence of the hyperactivation reaction of the renin-angiotensin system in cases with arterial luminal stenosis exceeding 80%
Summary
Renal autotransplantation (RAT) is a relatively well-documented practice. The concept was first introduced at the turn of the 20th century when Ullmann and Carrel performed the first RAT on animals. Hardy subsequently undertook the task of performing the first human RAT in the United States. The use of PCA may be ineffective or even harmful in patients with extensive renal artery involvement. This is more commonly seen in patients with Takayasu’s arteritis, dysplastic myofiber lesions and those with multiple vessel involvement [3]. Several studies have sought to determine the extent of vascular injury required to illicit hypertension, requiring subsequent invasive treatment. They have further demonstrated the absence of the hyperactivation reaction of the renin-angiotensin system in cases with arterial luminal stenosis exceeding 80%. RAT offers an effective alternative for those patients with multiple arterial lesions and clinical blood pressure control failure
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