Role of allograft nephrectomy following kidney graft failure: preliminary experience with pre-operative angiographic kidney embolization

• Published in: Journal of nephrology 2015-06, Vol.28 (3), p.379-385
• Main Authors: Al-Geizawi, Samer MT, Singh, Rajinder P., Zuckerman, Jack M., Requarth, Jay A., Farney, Alan C., Rogers, Jeffrey, Taussig, Jacob, Orlando, Giuseppe, Stratta, Robert J.
• Format: Article
• Language: English
• Subjects: Adult; Allografts; Blood Loss, Surgical - prevention & control; Blood Transfusion; Chi-Square Distribution; Delayed Graft Function - diagnostic imaging; Delayed Graft Function - etiology; Delayed Graft Function - therapy; Embolization, Therapeutic - adverse effects; Female; Humans; Kidney Transplantation - adverse effects; Length of Stay; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrectomy - adverse effects; Nephrology; North Carolina; Odds Ratio; Operative Time; Original Article; Preoperative Care; Radiography, Interventional - adverse effects; Reoperation; Retrospective Studies; Risk Factors; Time Factors; Treatment Failure; Urology
• ISSN: 1121-8428; 1724-6059
• DOI: 10.1007/s40620-014-0145-1

Introduction Allograft nephrectomy (AN) is not without morbidity following graft failure (GF) in kidney transplantation (KT). Methods Single center retrospective review of all adult patients undergoing AN following KT, including a subset of patients who underwent pre-operative angiographic kidney embolization (PAKE). Results Over a 104 month period, 853 adult patients underwent deceased donor KT. With a median follow-up of 3.5 years, 174 patients (20.4 %) developed GF and 38/174 (21.8 %) underwent AN. The rate of AN was higher in patients with delayed graft function [DGF, Odds Ratio (OR) 2.15, p = 0.023] and early GF (OR 1.7, p = 0.064). For patients undergoing PAKE (n = 13, mean timing of AN 27.5 months post-KT), the estimated intra-operative blood loss was reduced from a mean of 375 ± 530 to 100 ± 162 ml (p