Simultaneous kidney transplantation and ipsilateral native nephrectomy in patients with autosomal dominant polycystic kidney disease

Gadelkareem, Rabea Ahmed; Abdelgawad, Amr Mostafa; Mohammed, Nasreldin

doi:10.5500/wjt.v12.i9.310

WJT

2022

DOI: 10.5500/wjt.v12.i9.310

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Simultaneous kidney transplantation and ipsilateral native nephrectomy in patients with autosomal dominant polycystic kidney disease

Rabea Ahmed Gadelkareem¹,

Amr Mostafa Abdelgawad²,

Nasreldin Mohammed³

Abstract: The simultaneous kidney transplantation and ipsilateral native nephrectomy for autosomal dominant polycystic kidney disease does not seem to be associated with increased rates of comorbidity and complications. This outcome can efficiently be achieved when the indication and surgical approach of native nephrectomy are properly justified.

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2024

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Cited by 2 publications

References 9 publications

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Native nephrectomies in patients with autosomal dominant polycystic kidney disease: retrospective cohort study

Hogan,

McHale,

Dowling

et al. 2024

Ir J Med Sci

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Background Approximately 1 in 5 patients with autosomal dominant polycystic kidney disease (ADPKD) will undergo a native nephrectomy in their lifetime. These can be emergent or planned and the indications can range from space for kidney transplant, pain, hematuria and frequent urinary tract infections (UTIs). Due to the diverse nature of presentations, there is a lack of certainty about outcomes and optimal management. Aims This study aimed to evaluate preoperative indications and perioperative/postoperative complications in this patient cohort. Methods This retrospective review included 41 patients with ADPKD who underwent unilateral or bilateral nephrectomy in a single hospital between 2010 and 2020. We collected data on patient demographics, surgical indications, histological results and postoperative complications. We sourced this information using the hospital’s patient medical records. Results The main indications for nephrectomy were pain (39.5%) and bleeding (41.8%). Further indications included recurrent UTIs (16.3%), space for transplantation (27.9%), query malignancy (4.7%) and compressive gastropathy (2.3%). With regard to side, 55.8% were right-sided, 23.3% were left-sided, and 20.9% were bilateral. Seven percent of nephrectomy specimens demonstrated malignancy. Postoperative morbidity included requiring blood transfusion and long hospital stay. Thirty-seven percent of patients received a postoperative blood transfusion. There was no immediate or postoperative mortality associated with any of the cases reviewed. Conclusions In conclusion, this study demonstrates that native nephrectomy remains a safe operation for patients with ADPKD. Although further research is needed into, transfusion protocols, adjunctive therapies, such as TAE and research into timing of nephrectomy are still needed.

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Native nephrectomies in patients with autosomal dominant polycystic kidney disease: retrospective cohort study

Hogan,

McHale,

Dowling

et al. 2024

Ir J Med Sci

View full text Add to dashboard Cite

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Native nephrectomy in polycystic kidney disease patients on transplant lists: how and when?

Copur,

Ozbek,

Guldan

et al. 2024

J Nephrol

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Autosomal dominant polycystic kidney disease (ADPKD), the most common hereditary kidney disease, accounts for approximately 10% of the patients on kidney transplantation waitlists. High rates of complications including hemorrhage, infections, nephrolithiasis and kidney size-related compressive complaints have been reported among ADPKD patients. Therefore, the need for routine native nephrectomy and timing of such procedure in ADPKD patients being prepared for transplantation are debated. Even though pre-transplant nephrectomy has the potential to provide fewer infectious complications due to lack of immunosuppressive medication use, such procedure has been associated with longer hospital stay, loss of residual kidney function and need for dialysis. Although simultaneous nephrectomy and transplantation could potentially lead to longer perioperative duration, perioperative complications and need for blood transfusions, this was not confirmed in cohort studies. Therefore, some institutions routinely perform simultaneous unilateral nephrectomy and kidney transplantation. In this narrative review, our aim is to evaluate the current evidence regarding the need and timing of nephrectomy in ADPKD patients in relation to kidney transplantation. Graphical abstract

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Simultaneous kidney transplantation and ipsilateral native nephrectomy in patients with autosomal dominant polycystic kidney disease

Cited by 2 publications

References 9 publications

Native nephrectomies in patients with autosomal dominant polycystic kidney disease: retrospective cohort study

Native nephrectomies in patients with autosomal dominant polycystic kidney disease: retrospective cohort study

Native nephrectomy in polycystic kidney disease patients on transplant lists: how and when?

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