OBJECTIVE: To review retrospectively the Perth experience of autotransplantation for loin pain haematuria syndrome and identify possible factors associated with its failure. PATIENTS AND METHODS: The medical records of 11 women patients (median age 42 years, range 29-48) who had 12 autotransplantations were reviewed. All patients were then interviewed and asked whether they considered the operation a success. RESULTS: All patients initially had complete relief of symptoms. Three patients who had four transplants are still symptom-free with a follow-up of 24-46 months. Five patients have had partial relief with marked variability in their patterns of recurrent pain. Three patient have symptoms as severe as those before operation. One kidney was lost because of acute thrombosis and another developed a urinoma. No patient had deterioration in renal function. CONCLUSION: Renal autotransplantation is a treatment option of last resort, with acceptable morbidity in patients with intractable, functionally disabling renal pain, but three-quarters of these patients may develop recurrent pain in the transplant site. A current or past history of depression or absence of haematuria may represent risk factors for a poor post-operative prognosis. Treatment failure is predictable by a poor response to sympathetic neurolytic block.
OBJECTIVE: To review retrospectively the Perth experience of autotransplantation for loin pain haematuria syndrome and identify possible factors associated with its failure. PATIENTS AND METHODS: The medical records of 11 womenpatients (median age 42 years, range 29-48) who had 12 autotransplantations were reviewed. All patients were then interviewed and asked whether they considered the operation a success. RESULTS: All patients initially had complete relief of symptoms. Three patients who had four transplants are still symptom-free with a follow-up of 24-46 months. Five patients have had partial relief with marked variability in their patterns of recurrent pain. Three patient have symptoms as severe as those before operation. One kidney was lost because of acute thrombosis and another developed a urinoma. No patient had deterioration in renal function. CONCLUSION: Renal autotransplantation is a treatment option of last resort, with acceptable morbidity in patients with intractable, functionally disabling renal pain, but three-quarters of these patients may develop recurrent pain in the transplant site. A current or past history of depression or absence of haematuria may represent risk factors for a poor post-operative prognosis. Treatment failure is predictable by a poor response to sympathetic neurolytic block.
Authors: Robert P Baughman; Keith C Meyer; Ian Nathanson; Luis Angel; Sangeeta M Bhorade; Kevin M Chan; Daniel Culver; Christopher G Harrod; Mary S Hayney; Kristen B Highland; Andrew H Limper; Herbert Patrick; Charlie Strange; Timothy Whelan Journal: Chest Date: 2012-11 Impact factor: 9.410