Ex vivo renal perfusion and autotransplantation in treatment of calculous disease or abdominal aortic aneurysm.

Two more indications are described for temporary ex vivo perfusion of kidneys with revascularization of these organs as auto grafts to orthotopic or heterotopic locations. One of the patients had staghorn calculi which were removed from a solitary kidney. The other patient had both kidneys autografted in the course of a surgical procedure on an extensive abdominal aortic aneurysm. The term "bench surgery" to describe reconstructive surgery on diseased kidneys receiving asanguineous perfusion outside the body was coined by Guerriero, Scott, and Joyce. 1 The objective of carrying out complex extracorporeal operative procedures in an asanguineous state was made possible by the instruments and techniques which were developed by Belzer, Ashby, and Dunphy2 to preserve cadaveric kidneys for renal homotransplantation. The first uses of bench surgery were reported by Corman et al. 3 Their report and subsequent ones about bench surgery have shown how this sophisticated approach is a significant advance in urologic operative procedures. So far, kidney salvage has been achieved after traumatic injury, 3 with renal carcinoma in a *The work was supported by research grants from the Veterans Administration; by Grants AI-AM-08898 and AM-07772 from the National Institutes of Health; and by Grants RR-00051 and RR-00069 from the General Clinical Research Centers Program of the Division of Research Resources, National Institutes of Health. UROLOGY / MARCH 1975 / VOLUME V, NUMBER 3 single kidney, 4 with renal arterial atherosclerosis, fibrous dysplasia, or aneurysm, 3-6 and with deficiencies in ureteral length. 4 In this report two more uses of bench surgery will be described. One patient had staghorn calculi in his remaining kidney and had been refused surgical intervention at at least two other major urology centers. The other patient had an abdominal aortic aneurysm with abnormalities of both renal arteries and early renal failure.