[Second transplant into the same iliac fossae: The importance of first transplant location]. / Retrasplantar en la misma fosa ilíaca: una necesidad cada vez más presente. Importancia de la ubicación del primero transplante.

OBJECTIVES: To report our personal experience in the reusability of the iliac fossa for renal transplantation (RT) when there are not more favorable options. METHODS: Of a total of 645 kidney transplantations, which include 52 living-donor transplantations, and three combined kidney-pancreas ones, we have selected seven, in six patients, in whom the same iliac fossa of a previous RT was reused. RESULTS: The cases reported were preceded by renal grafts placed on lumbariliac position, as Gil Vernet described at 1964, varying the classic situation. Transplantectomies were always performed using the extra capsular technique. We do think that those two circumstances have facilitated the second location of the graft.

[Asynchronic bilateral renal cell carcinoma: Radical and in situ hypothermia nephron sparing surgeries]. / Carcinoma de células renales bilateral y asincrónico: cirugía radical y conservadora con hipotermia in situ.

OBJECTIVES: To present the double action a urologist has to consider in front of a Renal cell carcinoma (RCC); on one hand, when the normality of the contralateral kidney is stated and, on the other hand when, forced by the existence of the tumor in a solitary kidney, it is mandatory to perform a surgical technique to preserve renal function. METHOD: The case of a 43 year-old patient, diabetic who in 1982 underwent left radical nephrectomy for RCC diagnosed during a diagnostic work up for hypertension (HTA). Ten years later an upper pole renal tumor is found in the remaining kidney. Nephron-sparing surgery with in situ hypothermia was performed. RESULTS: The patient died 18 years after the first surgery and 8 years after the second. Death was due to diabetic decompensation, haemorrhage from a gastric ulcer and "retroperitoneal mass probably pancreatic" that was not characterized. CONCLUSIONS: The PSA decline, the histology of the prostate during the adenomectomy and the morphometric changes after surgery and at mid-term, advise a more accurate value of PSA in patients who underwent open sugery, in order to detect a carcinoma in the residual prostate gland.