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

Al-Geizawi, S.; Singh, Rajinder; Zuckerman, Jack M.; Requarth, Jay A.; Farney, Alan C.; Rogers, Jeffrey; Taussig, Jacob; Orlando, Giuseppe; Stratta, Robert J.

doi:10.1007/s40620-014-0145-1

Cited by 8 publications

(3 citation statements)

References 26 publications

(70 reference statements)

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“…The same finding was reproduced by Al‐Geizawi et al . . In our study, although it was reported in four of five patients (80%), wound site‐related infection was the only complication after subsequent surgical removal, of which the evolution was generally favourable with drainage and local care.…”

Section: Discussioncontrasting

confidence: 46%

Renal graft intolerance syndrome in late graft failure patients: efficacy and safety of embolization as first-line treatment compared to surgical removal

et al. 2017

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Although renal graft percutaneous embolization was introduced to avoid the risk associated with graft nephrectomy, there is no universal consensus about its indications and results. In order to evaluate the efficacy of graft embolization in the treatment of graft intolerance syndrome as well as its safety compared to surgical removal with respect to complications and other morbidity measures, We performed a retrospective observational study comparing two groups of patients treated for graft intolerance syndrome: Group 1: patients who had embolization as first-line treatment and Group 2: patients directly treated by surgical removal. 72 patients were included, (32 in Group 1 and 40 in Group 2); the postintervention follow-up continued for 12 months. Patients in Group 1 are older than those in Group 2. Otherwise, the two groups are similar concerning sex, manifestations of graft intolerance syndrome, diabetes and nutritional and functional status. The overall success rate of embolization in complete resolution of graft intolerance syndrome and ultimately avoidance of surgical removal was 84.37%. The surgical removal group had more serious complications, a longer hospital stay and needed more blood transfusions. We conclude that embolization of symptomatic renal grafts has considerable efficacy with less morbidity, and no serious complications compared to the standard surgical graft removal.

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Section: Discussioncontrasting

confidence: 46%

Renal graft intolerance syndrome in late graft failure patients: efficacy and safety of embolization as first-line treatment compared to surgical removal

et al. 2017

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“…However, the risk on necrotic pyelonephritis and post-embolization syndrome are increased after RAE and RAE as monotherapy is not widely used (200). However, using RAE as neo-adjuvant intervention before GN was shown to reduce both blood loss and operating time (201)(202)(203).…”

Section: Alternativesmentioning

confidence: 99%

Pearls and Pitfalls in Pediatric Kidney Transplantation After 5 Decades

et al. 2022

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Worldwide, over 1,300 pediatric kidney transplantations are performed every year. Since the first transplantation in 1959, healthcare has evolved dramatically. Pre-emptive transplantations with grafts from living donors have become more common. Despite a subsequent improvement in graft survival, there are still challenges to face. This study attempts to summarize how our understanding of pediatric kidney transplantation has developed and improved since its beginnings, whilst also highlighting those areas where future research should concentrate in order to help resolve as yet unanswered questions. Existing literature was compared to our own data of 411 single-center pediatric kidney transplantations between 1968 and 2020, in order to find discrepancies and allow identification of future challenges. Important issues for future care are innovations in immunosuppressive medication, improving medication adherence, careful donor selection with regard to characteristics of both donor and recipient, improvement of surgical techniques and increased attention for lower urinary tract dysfunction and voiding behavior in all patients.

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“…These graft-related complications can be avoided by using RAE as a “neo-adjuvant” intervention, one or two days before GN. This combined approach appears to reduce the intraoperative blood loss [ 24 – 26 ] and operative time of GN [ 24 , 26 ]. Less common complications of RAE include arterial pseudoaneurysm [ 27 ] and coil migration with limb embolisation [ 28 ].…”

Section: Non-surgical Devascularisationmentioning

confidence: 99%

Graft nephrectomy in children

Phillips

Callaghan

2017

Pediatr Nephrol

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Kidney transplantation is recognised as the gold standard treatment of end-stage renal disease in most children, with excellent graft survival rates. When graft failure occurs, renal transplant recipients (RTRs) have the option of removal of the transplant (graft nephrectomy [GN]), or leaving the failed transplant in situ. The aims of this review are to discuss the indications for GN, surgical techniques, outcomes after GN (including risks of allosensitisation and the impact on subsequent transplants), and the possible role of routine GN in the asymptomatic RTR with a failed renal allograft. Literature in both the pediatric and adult renal transplant fields is reviewed. We also discuss how future research in this area could advance our knowledge of which patients to select for GN, and the most appropriate surgical approach.

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

Abstract: Delayed graft function and early GF are associated with a higher rate of AN. PAKE may result in less blood loss, fewer transfusions, reduced operating time, and shorter length of stay, which may translate into reductions in morbidity.

Cited by 8 publications

References 26 publications

Renal graft intolerance syndrome in late graft failure patients: efficacy and safety of embolization as first-line treatment compared to surgical removal

Renal graft intolerance syndrome in late graft failure patients: efficacy and safety of embolization as first-line treatment compared to surgical removal

Pearls and Pitfalls in Pediatric Kidney Transplantation After 5 Decades

Graft nephrectomy in children

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