Fundació Puigvert↗︎
L’autotransplantation of the kidney is a high-complexity reconstructive surgery that consists of removing a kidney from the same person and re-implanting it, usually in another area of the abdomen. Unlike a conventional kidney transplant, there is no donor person or external organ: the same kidney is preserved and re-implanted. This technique is reserved for very selected situations where there is a complex problem with the blood vessels of the kidney or the urinary tract that cannot be adequately resolved with other procedures. The main objective is to preserve the kidney and its function, avoiding definitive removal whenever possible. In a kidney autotransplant, the kidney is first extracted while keeping the necessary structures intact for reimplantation. Depending on the problem that prompted the intervention, the kidney may be treated outside the body, for example, to reconstruct complex blood vessels. It is then reimplanted, usually in the lower abdomen, similarly to the implantation of a transplanted kidney. The blood vessels of the kidney are connected to those of the person so that the organ can regain blood flow, and when necessary, the ureter is reconnected to the bladder to restore the passage of urine. Changing the position of the kidney allows, in certain situations, to resolve problems that would be very difficult to treat while keeping it in its usual location. For example, it can facilitate the reconstruction of complex injuries to the ureter or renal blood vessels. Historically, these have been two of the main indications for kidney autotransplantation. In particularly complex cases, extraction also allows for work on the kidney outside the body with greater control over its structures before reimplantation. Kidney autotransplantation can also be performed, in selected individuals, using robot-assisted surgery. This allows for different phases of the intervention to be carried out with a minimally invasive approach and provides enhanced vision and highly precise articulated instruments to perform delicate vascular and urinary connections. There are different technical modalities, depending on whether certain phases of preparation and reconstruction of the kidney are carried out inside or outside the body. Current literature considers robotic kidney autotransplantation a promising evolution of the conventional technique, but the available evidence is still limited and is mainly based on small series of highly selected individuals. Read more about: Urological robotic surgery. Renal autotransplantation is an exceptional and highly specialized option. It can be considered when other less complex reconstructive techniques do not adequately solve the problem while preserving the kidney. Among the main situations in which it can be proposed are: One of the most relevant applications of autotransplantation is the treatment of extensive or complex injuries of the ureter. By relocating the kidney to a lower position, the distance to the bladder is reduced, and the urinary tract can be reconstructed without necessarily having to replace a long segment of the ureter. However, there are currently several reconstructive alternatives, some of which are also minimally invasive. For this reason, autotransplantation is usually reserved for the most complex cases where these options are not suitable. When there is a very complex renal vascular injury, the kidney can be temporarily removed to facilitate reconstruction under controlled conditions. It is then reimplanted and connected to the blood vessels to restore blood flow. This strategy can allow for the preservation of a kidney that, under certain circumstances, may need to be permanently removed. Autotransplantation involves complex surgery, and the indication must be carefully evaluated. The function of the kidney, the anatomy of the blood vessels and urinary tract, previous interventions, general health status, and available alternatives must be studied. The goal is not to use the most complex technique, but to determine which option allows for solving the problem while preserving kidney function with the best possible balance between benefits and risks. Get to know our Urology Service. Is a kidney autotransplant the same as a kidney transplant? No. In a conventional kidney transplant, the kidney comes from another person. In an autotransplant, your own kidney is removed and reimplanted in another location. Read more about: Kidney transplant. Will I need medication to prevent rejection? Not because you had the autotransplant. Since it is your own kidney, the immune system does not recognize it as a foreign organ and no rejection treatment (immunosuppression) is needed for this reason. Why is the kidney removed if it is going to be reimplanted? Because, in certain situations, removing it allows for the repair of complex blood vessel injuries or solves urinary tract problems that would be very difficult to treat with the kidney in its usual position. Where is the kidney placed after the autotransplant? It is usually implanted in the lower abdomen, in a position similar to that used in a conventional kidney transplant. This allows it to be connected to the blood vessels of the pelvis and facilitates the reconstruction of the urinary tract. Does the autotransplant help avoid losing the kidney? This is one of its main objectives. In very selected individuals, it can be considered as an alternative to preserve the kidney and its function when other techniques do not adequately solve the problem. However, this does not mean that it is possible to preserve it in all cases. Can the autotransplant be performed with robotic surgery? Yes. In selected cases, a robot-assisted kidney autotransplant can be performed, combining the principles of transplant surgery with a minimally invasive approach. It is a highly complex technique that requires specific experience. Read more about: Urological robotic surgery. What advantages can the robotic approach provide? Robotic surgery provides enhanced vision and articulated instruments that facilitate very precise movements. Available studies indicate that the robotic approach is feasible and can provide perioperative advantages in selected individuals, but there is still little comparative evidence and the results depend heavily on case selection and the experience of the team. Read more about: Urological robotic surgery. Is it a common procedure? No. Kidney autotransplant is an uncommon surgery, reserved for complex and highly selected situations where simpler alternatives are not suitable.
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What is it?
Specific information about the procedure
How is it performed?
Why is the kidney relocated?
Robot-assisted autotransplantation
Techniques and indications
When can it be indicated?
Reconstructive surgery of the ureter
Vascular reconstruction
An individualized decision
Organization and care team
Frequently asked questions
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