Native Nephrectomy in Renal Transplant Recipients With Autosomal-Dominant Polycystic Kidney Disease

Chebib, Fouad T.; Prieto, Mikel; Jung, Yeonsoon; Irazabal, Maria V.; Kremers, Walter K.; Dean, Patrick G.; Rea, David; Cosio, Fernando G.; Torres, Vicente E.; El-Zoghby, Ziad M.

doi:10.1097/txd.0000000000000554

Cited by 36 publications

(43 citation statements)

References 19 publications

(21 reference statements)

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“…In a study undertaken by Chebib et al, among the 470 renal transplant recipients with ADPKD, 24.3% underwent nephrectomy (19), a percentage similar to that of Patel et al (17). The general approach of these investigators was to avoid concomitant or bilateral nephrectomy, due to concerns regarding morbidity and graft survival.…”

Section: Resultsmentioning

confidence: 99%

“…The selection of appropriate surgical technique is also a matter of controversy, with the laparoscopic and handassisted approach gradually gaining more ground. Although technically challenging, a great number of studies, including a recent meta-analysis, indicated that laparoscopic nephrectomy, especially hand-assisted bilateral nephrectomy, is both safe and efficacious even for massively enlarged kidneys (19,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34).…”

Section: Discussionmentioning

confidence: 99%

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Tailoring the ‘Perfect Fit’ for Renal Transplant Recipients with End-stage Polycystic Kidney Disease: Indications and Timing of Native Nephrectomy

Argyrou

Moris

Vernadakis

2017

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Tailoring the ‘Perfect Fit’ for Renal Transplant Recipients with End-stage Polycystic Kidney Disease: Indications and Timing of Native Nephrectomy

Argyrou

Moris

Vernadakis

2017

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“…Нефрэктомия ПКП по клиническим показаниям или с целью освобождения анатомического пространства для трансплантации показана 25-35% пациентов с АДПП [5]. Среднее количество операций, выполненных в связи с осложнениями поликистоза после трансплантации, дости-гает 20% [5,6]. Ряд авторов считают, что нет необходимости в рутинном предварительном удалении почек при бессимптомном течении заболевания [6].…”

Section: Introductionunclassified

Results of kidney transplantation in patients with end-stage renal failure caused by autosomal dominant polycystic kidney disease

Дайнеко

Ананьев

Невирович

et al. 2019

RJTAO

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Aim. To investigate the renal transplantation results for patients with end-stage renal disease (ESRD) due to autosomal dominant polycystic kidney disease (PKD). Materials and methods. The study included a prospective and retrospective analysis of the kidney transplantation results in 46 patients with ESRD caused by PKD, performed in the period from 2003 to 2018. Two groups of patients were formed. The comparison group consisted of 23 (50%) cases of kidney transplantation in patients whose polycystic-changed kidneys were preserved at the time of transplantation. The study group included 23 (50%) patients who underwent pretransplantation nephrectomy of native kidneys for clinical indications or to prepare for the waiting list. During the study, an algorithm of examination and surgical preparation for inclusion patients with PKD in the waiting list for kidney transplantation was developed and actively used. Results. The mean follow up period of patients who underwent pretransplantation nephrectomy was 3.6 ± 2.5 years, patients with preserved native kidneys-5.3 ± 3.08 years (p > 0.05). Periodic pain in the lumbar region disturbed 12 (52.2%) patients with preserved polycystic-changed kidneys. The frequency of episodes of leukocyturia, bacteriuria and(or) hematuria significantly differed and amounted to 0.27 ± 0.35 cases per year in the study group, 1.49 ± 0.54 (p < 0.05) in the comparison group. Posttransplant nephrectomy of polycystic-changed kidneys at different times after transplantation was required in 5 (21.7%) patients. Five-year graft survival in the study group was 87.5%, in the comparison group-76.1%. Among the patients of the comparison group, 76.4% of transplants lost their function after 10 years. The 5 and 10-year survival rates of patients with preserved native kidneys were 90.5% and 80%, respectively. In particular, there was one fatal outcome due to sepsis on the background of infection with cysts of preserved polycystic kidney. There were no deaths in the study group. Conclusion. Among patients whom polycystic-changed kidneys removed, there is a more favorable course of the post-transplant period due to the low frequency of infectious complications. More than 60% of patients with PKD need to perform nephrectomy of native kidneys during life for various reasons, including more than 21,7% need it after kidney transplantation due to complications during immunosuppressive therapy. Reasonable assessment of the polycystic kidneys and timely pretransplantation nephrectomy are an integral part of the preparation and management of the waiting list for transplantation of a patient with PKD.

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“…Не существует единого мнения по поводу сро-ков и необходимости удаления поликистозно-из-мененных почек [6][7][8]. Традиционно нефрэктомия больным с АДПП выполняется с использовани-ем открытого трансабдоминального доступа или люмботомии.…”

Section: Introductionunclassified

The use of laparoscopic nephrectomy in patients with autosomal dominant polycystic kidney disease

Резник

Николаевич²,

Ananiev

et al. 2016

UroVed

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1 ГБУ «СПБ НИИ Скорой помощи им И.И. Джанелидзе», Санкт-Петербург; 2 ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова» Минздрава России Дата поступления: 14.10.2016 Статья принята к печати: 12.12.2016В ходе исследования проведен анализ результатов лечения 32 пациентов с аутосомно-доминант-ным поликистозом почек (АДПП). В период с 2014 по 2016 г. этим больным была выполнена нефрэк-томия по клиническим показаниям и в целях подготовки к трансплантации почки. Первой группе (15 пациентов) выполнены открытые оперативные вмешательства с использованием срединной ла-паротомии и люмботомии (16 операций), из них: билатеральная нефрэктомия -11 (68,7 %), моно-латеральная нефрэктомия -5 (31,3 %). Во второй группе (17 пациентов) для выполнения монолате-ральной нефрэктомии использован лапароскопический трансабдоминальный доступ (24 операции). Средняя длительность лапароскопических и открытых оперативных вмешательств значимо не от-личалась и составила 146 ± 14 и 134 ± 15 минут (p > 0,05). Максимальный размер удаленных по-ликистозно-измененных почек в первой группе 22,5 ± 4,27 см, во второй -21,5 ± 3,9 см (p > 0,05). Частота послеоперационных осложнений в первой и второй группах составил 43,75 и 12,5 % случаев соответственно. Имел место 1 (6,25 %) случай летального исхода в первой группе. Средний после-операционный койко-день в первой группе -13-14 (13,7 ± 1,3), во второй -7-8 (7,6 ± 0,4, p < 0,05). Пациенты после лапароскопических вмешательств активизированы на 2-3 сутки (2,5 ± 0,13), после открытых операций на 4-5 (4,13 ± 0,39, p < 0,05). Лапароскопические технологии позволяют зна-чительно снизить частоту послеоперационных осложнений и расширить возможности применения нефрэктомии при лечении пациентов с АДПП. Лапароскопический трансабдоминальный доступ ха-рактеризуется более благоприятным течением послеоперационного периода после нефрэктомии, по-зволяет уменьшить продолжительность стационарного лечения и активизировать больных в ранние сроки.Ключевые слова: лапароскопическая нефрэктомия; аутосомно-доминантный поликистоз почек; трансплантация почки.

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Native Nephrectomy in Renal Transplant Recipients With Autosomal-Dominant Polycystic Kidney Disease

Abstract: Supplemental digital content is available in the text.

Cited by 36 publications

References 19 publications

Tailoring the ‘Perfect Fit’ for Renal Transplant Recipients with End-stage Polycystic Kidney Disease: Indications and Timing of Native Nephrectomy

Tailoring the ‘Perfect Fit’ for Renal Transplant Recipients with End-stage Polycystic Kidney Disease: Indications and Timing of Native Nephrectomy

Results of kidney transplantation in patients with end-stage renal failure caused by autosomal dominant polycystic kidney disease

The use of laparoscopic nephrectomy in patients with autosomal dominant polycystic kidney disease

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