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

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

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Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2013-02, Vol.28 (2), p.466-471
Main Authors: Neeff, Hannes Philipp, Pisarski, Przemyslaw, Tittelbach-Helmrich, Dietlind, Karajanev, Konstantin, Neumann, Hartmut P H, Hopt, Ulrich Theodor, Drognitz, Oliver
Format: Article
Language:English
Subjects:
Adult
Aged
Female
Follow-Up Studies
Graft Survival
Humans
Kidney - physiology
Kidney Failure, Chronic - mortality
Kidney Failure, Chronic - surgery
Kidney Transplantation - physiology
Male
Middle Aged
Nephrectomy - methods
Polycystic Kidney, Autosomal Dominant - mortality
Polycystic Kidney, Autosomal Dominant - surgery
Retrospective Studies
Survival Rate
Treatment Outcome
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Summary:Surgical management of autosomal dominant polycystic kidney disease (ADPKD) in patients awaiting renal transplantation is a challenging task. 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). 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. Renal transplantation with simultaneous unilateral nephrectomy in ADPKD is a reasonable procedure for patients suffering from massively enlarged native kidneys.
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/gfs118