Twenty-four patients underwent ex vivo renal artery reconstruction of 26 extensive lesions using continuous hypothermic perfusion and replacement of the diseased renal artery with a hypogastric artery autograft. Postoperative acute tubular necrosis was avoided in these repaired kidneys. There was one postoperative graft occlusion accounting for the only failure in the series. Of the hypertensive patients, 95% were cured or improved during the follow-up period extending from six months to six years. Six of these patients have been followed more than three years and late postoperative arteriograms showed no alteration in their autografts. This method, therefore, extends the potential for renal artery reconstruction to most renal vascular lesions, reserving nephrectomy for the infarcted or severely atrophic kidney only.
