Two cases of complex renal artery aneurysms treated with renal autotransplantation

Objective To report on the surgical treatment of complex renal artery aneurysms (RAAs) using kidney autotransplantation in two patients at a single institution.Methods We retrospectively reviewed two cases of patients with RAA treated with renal autotransplantation at a single center over a period of 15 years.Results Case 1: A 50-year-old male presented to the outpatient clinic with left flank and lumbar pain. A CT scan revealed a 25 mm aneurysm at the left renal pelvis and bilateral renal fibromuscular dysplasia. A laparoscopic left nephrectomy was performed, followed by bench aneurysm resection, saphenous vein bypass reconstruction, and kidney autotransplantation into the right iliac fossa. At 11 years follow-up, his renal function remains normal, with adequate patency and function of the transplanted kidney. Case 2: A 51-year-old male reported a 6-month history of nonspecific abdominal pain. A CT scan revealed nephrolithiasis and multiple renal artery aneurysms, the largest measuring 50.2 mm in his right kidney. He underwent laparoscopic right nephrectomy and renal autotransplantation in the right iliac fossa. At 3 years follow-up, the patient remains asymptomatic with normal renal function.Conclusion Ex vivo autotransplantation is an acceptable option for addressing complex RAAs beyond the bifurcation of the main renal artery.