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Renal Autotransplantation; Case Series

Conditions
Renal Vascular Disease
Renal Tumor
Nutcracker Syndrome, Renal
Pelvic Trauma
Loin Pain-Hematuria Syndrome
Congestion, Venous
Interventions
Procedure: Pre-Operative Information
Procedure: Intra-Operative Data
Other: Post-Operative Data (up to discharge)
Other: Short-Term Follow-Up Data
Registration Number
NCT05115812
Lead Sponsor
Methodist Health System
Brief Summary

Renal autotransplantation (RAT) is a method of removing a kidney from its place of origin in a patient, repairing it, and transplanting it in another location of the body, generally the iliac fossa of the same patient.RAT is a relatively new technique; the first ever RAT procedure in the US was performed in 1963. Advances in preservation and transplantation techniques have made RAT a modality that can be utilized in complex renal diseases. RAT is indicated for conditions such as renal vascular disease, nutcracker syndrome, pelvic venous congestion, pelvic trauma, refractory stone disease and, in some cases, loin pain hematuria syndrome and conventionally unresectable renal tumors.

Irrespective of the excellent outcomes shown by RAT, the conventional open approach requires a large midline xiphoid-to-pubis or flank incision for donor nephrectomy with a second pelvic incision for renal transplantation into the iliac fossa.The current gold standard approach to RAT is a laparoscopic nephrectomy followed by open auto-transplantation. However, this approach still requires a large pelvic incision. Robotic technology enables us to perform more complex minimally invasive surgery. Gordon et al. performed and reported the first completely intracorporeal robotic RAT to repair a ureteral injury in 2014.

Detailed Description

This is a retrospective chart review case series study of all consecutive cases in which robotic RAT was performed that meet the study inclusion and exclusion criteria. The case series will be performed starting from January 2018 until June 2021 to include all cases of robotic RAT procedures.

Perioperative and short-term clinical data will be obtained from the EMR. All the data variables will be documented in the case report forms.

Because the data will have been de-identified and is archival in nature, there will be no active subject recruitment and no patient consenting is required.

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Subject was 18 years or older at the time of the procedure
  • Subject who has undergone robotic RAT irrespective of the underlying etiology.
Exclusion Criteria
  • Subjects who do not meet the inclusion criteria

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
RATIntra-Operative Datapatients having undergone robotic-assisted RAT procedure
RATPost-Operative Data (up to discharge)patients having undergone robotic-assisted RAT procedure
RATPre-Operative Informationpatients having undergone robotic-assisted RAT procedure
RATShort-Term Follow-Up Datapatients having undergone robotic-assisted RAT procedure
Primary Outcome Measures
NameTimeMethod
Baseline patient characteristicsJanuary 2018 until June 2021

Demographics-age

Baseline patient characteristics- HypertensionJanuary 2018 until June 2021

Medical History: hypertension

Baseline patient characteristics-indication for RAT (Renal AutotransplantationJanuary 2018 until June 2021

Medical History: indication for RAT (Renal Autotransplantation)

Baseline patient characteristics-lesionsJanuary 2018 until June 2021

Medical History: lesions

Baseline patient characteristics- Tobacco useJanuary 2018 until June 2021

Medical History: tobacco use

Baseline patient characteristics- GenderJanuary 2018 until June 2021

Demographics: gender

Baseline patient characteristics-previous renal revascularizationJanuary 2018 until June 2021

Medical History: previous renal revascularization

intraoperative characteristics-Operative timeJanuary 2018 until June 2021

Operative time

Baseline patient characteristics- BMIJanuary 2018 until June 2021

BMI, based on the American Society of Anesthesiologists status classification

Baseline patient characteristics- DiabetesJanuary 2018 until June 2021

Medical History: diabetes

Baseline patient characteristics-cardiopulmonary diseaseJanuary 2018 until June 2021

Medical History: cardiopulmonary disease

intraoperative characteristics-concomitant proceduresJanuary 2018 until June 2021

concomitant procedures

intraoperative characteristics-conversionsJanuary 2018 until June 2021

conversions

post-operative characteristics-Post-operative adverse eventsJanuary 2018 until June 2021

Post-operative adverse events

intraoperative characteristics-autotransplantation techniqueJanuary 2018 until June 2021

autotransplantation technique

post-operative characteristics-hospital length of stayJanuary 2018 until June 2021

hospital length of stay

post-operative characteristics-information on enhanced recovery programJanuary 2018 until June 2021

information on enhanced recovery program

Baseline patient characteristics-serum creatinine levelJanuary 2018 until June 2021

Medical History: serum creatinine level

short-term clinical data-Adverse events,up to 30 days post discharge

Adverse events, re- admissions, re-operations related to the index procedure

intraoperative characteristics-total OR timeJanuary 2018 until June 2021

total OR time

intraoperative characteristics-transfusionsJanuary 2018 until June 2021

transfusions

intraoperative characteristics-intraoperative adverse eventsJanuary 2018 until June 2021

intraoperative adverse events

post-operative characteristics-discharge statusJanuary 2018 until June 2021

discharge status

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Liver Institute of Methodist Dallas Medical Center

🇺🇸

Dallas, Texas, United States

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