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Complex renal surgery was defined by the Kidney Committee of the British Association of Urological Surgeons as “a surgical procedure in which two or more separate complex procedures are performed upon the kidney. Examples are: a radical nephrectomy for renal cell carcinoma, renal autotransplantation, extirpative nephrectomy and enucleation of a renal tumour and the more elaborate interventions such as renal artery reconstruction, nephropexy, excision of a space-occupying lesion and various reconstructive surgical procedures.” Renal vascular reconstruction has evolved rapidly over the past decade, with the development of better techniques, and the renal autotransplantation operation gained in importance because of the apparent advantages of a decrease in the length of convalescence, avoidance of a severe reduction in the glomerular filtration rate, and possible protection of a sick kidney against the hazards of haemodialysis. The prerequisites for a successful operation are a meticulous preoperative assessment of the patient, appropriate theatre facilities and the availability of highly specialised surgical teams. The complementary functions of the radiologist and anaesthetist are crucial in the successful achievement of adequate clinical results and the operative technique should be in the hands of dedicated surgeons.Living cells display an enormous level of robustness to a variety of micro- and nanoscale damage events. These so-called “cellular robustness” properties have been attributed to the dynamic nature of the genetic material in their genome and the complex dynamic network of cross-talk signals between the cell and its environment. For example, cellular robustness has been studied in a wide range of processes including oxidative stress, DNA damage, transcriptional regulation and protein homeostasis. However, the cell also encounters random environmental stresses caused by its environment and many of these small-scale damage events can have large consequences for the
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