[Simultaneous allotransplantation of the adrenal gland and the kidney].

Thirteen months after a bilateral nephrectomy for a synchronous bilateral renal cell carcinoma involving both adrenal glands, a 46 years-old man underwent a simultaneous adrenal and kidney allotransplantation. The left renal allograft was harvested together with a ipsilateral adrenal gland using a common aortic patch. Maintenance immunosuppression was based on azathioprine, antilymphocyte globulin cyclosporine and prednisolone. Kidney allograft function remained stable for 5 years until the patient died from multifocal pancreatic metastases. Clinical, biochemical, radiological and histological arguments demonstrated the function of adrenal allograft. To our knowledge, it is the first report of a simultaneous kidney and adrenal gland allotransplantation in a therapeutic intent. An adrenal gland allotransplantation is only justified when the adrenal insufficiency exists with an end stage organ failure requiring transplantation and therefore immunosuppressive drugs.