Journal Article

One hundred consecutive kidney transplantations with simultaneous ipsilateral nephrectomy in patients with autosomal dominant polycystic kidney disease

Hannes Philipp Neeff, Przemyslaw Pisarski, Dietlind Tittelbach-Helmrich, Konstantin Karajanev, Hartmut P.H. Neumann, Ulrich Theodor Hopt and Oliver Drognitz

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 28, issue 2, pages 466-471
Published in print February 2013 | ISSN: 0931-0509
Published online October 2012 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfs118
One hundred consecutive kidney transplantations with simultaneous ipsilateral nephrectomy in patients with autosomal dominant polycystic kidney disease

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Purpose

Surgical management of autosomal dominant polycystic kidney disease (ADPKD) in patients awaiting renal transplantation is a challenging task.

Methods

From 1998 to 2009, a total of 100 consecutive renal transplantations with simultaneous unilateral nephrectomy were performed in 59 men and 41 women with ADPKD and end-stage renal failure. About 38% received kidney allografts from living donors. The ipsilateral polycystic kidney was removed at the time of renal transplantation. Immunosuppressive therapy was not modified. Cold ischaemia time was 155 (38–204 min) versus 910 min (95–2760 min) for living versus deceased donor transplantation. Mean weight of removed kidneys was 2002 g (414–8850 g). Mean follow-up was 3.0 years (0.8–10.0 years).

Results

Overall patient and graft survival were 97 and 96% at 1 year and 93 and 80% at 5 years, respectively. Serum creatinine at current follow-up was 1.49 (0.8–2.8) mg/dL. Surgical complications, which might be associated with simultaneous nephrectomy requiring re-operation, occurred in 12% (lymphocele 4%, hernia 4%, post-operative haematoma or bleeding 4%). None of the patients died peri-operatively.

Conclusion

Renal transplantation with simultaneous unilateral nephrectomy in ADPKD is a reasonable procedure for patients suffering from massively enlarged native kidneys.

Keywords: adult kidney transplantation; nephrectomy; polycystic kidney disease; survival; surgical complications

Journal Article.  3187 words.  Illustrated.

Subjects: Nephrology

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