Extracorporeal renal surgery for renovascular hypertension.

Nine cases of renovascular hypertension caused either by lesions in the distal part of the renal artery or by proximal renal atery stenosis where local reconstruction was considered dangerous were treated by extracorporeal reconstructive surgery and autotransplantation. The kidney were removed, cooled and preserved by simple hypothermia during workbench reconstruction on a separate side table. After reconstruction the kidneys were reimplanted to the groin. One kidney was lost due to infection and bleeding. All patients were preoperatively severely hypertensive. Blood pressure was normalized in all cases but one with a homotransplanted kidney which also was undergoing chronic rejection. The method is simple and safe and offers new possibilities to treat lesions in the kidney which previously were impossible or very risky to treat surgically. It is a safe alternative to conventional methods in case of anatomical structures making local reconstruction difficult.