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

Argyrou, Chrysoula; Moris, Demetrios; Vernadakis, Spiridon

doi:10.21873/invivo.11060

Cited by 30 publications

(29 citation statements)

References 30 publications

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“…The term polycystic kidney disease should be reserved for two hereditary diseases: autosomal recessive polycystic kidney disease (ADPKD) and, most commonly, autosomal dominant polycystic kidney disease (ADPKD) [1, 2]. ADPKD is characterized by relentless development and growth of cysts causing progressive kidney enlargement associated with hypertension, abdominal fullness and pain, episodes of cyst haemorrhage giving rise to gross haematuria, nephrolithiasis, cyst infections, and progressive renal failure (Figure 1) [3].…”

Section: Introductionmentioning

confidence: 99%

Pretransplant Nephrectomy for Large Polycystic Kidneys in ADPKD (Autosomal Dominant Polycystic Kidney Disease) Patients: Is Peritoneal Dialysis Recovery Possible after Surgery?

Ietto

Raveglia

Zani

et al. 2019

BioMed Research International

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The choice of modality for renal replacement therapy in patients with ADPKD varies, often based on patient choice, physician-related factors, and resource availability. For a long time peritoneal dialysis (PD) was considered as relative contraindication due to the possible limited intraperitoneal space. In recent years, some studies suggested it is a valid option also in patients with ADPKD to be considered as a first line treatment in potentially fit patients. Diuresis volume lowering and potential permanent damage of peritoneal integrity, both leading to a necessary switch to haemodialysis, are the two most important dangers after nephrectomy, especially if bilateral, in PD patients. We performed a retrospective analysis of patient underwent native polycystic kidney nephrectomy in order to state the possibility to recover peritoneal dialysis after surgery.

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Section: Introductionmentioning

confidence: 99%

Pretransplant Nephrectomy for Large Polycystic Kidneys in ADPKD (Autosomal Dominant Polycystic Kidney Disease) Patients: Is Peritoneal Dialysis Recovery Possible after Surgery?

Ietto

Raveglia

Zani

et al. 2019

BioMed Research International

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“…The program suggests that no pre-transplant nephrectomy is indicated in asymptomatic patients. In symptomatic patients, residual diuresis ought to be included as an additional parameter in the decision making [12]. In recipients with residual diuresis, pre-transplant unilateral nephrectomy should be favored.…”

Section: Discussionmentioning

confidence: 99%

“…In recipients with residual diuresis, pre-transplant unilateral nephrectomy should be favored. In living donation, the simultaneous procedure is preferred [12]. In the absence of diuresis, the algorithm recommends a bilateral pre-transplant or simultaneous nephrectomy (if living donor KTx).…”

Section: Discussionmentioning

confidence: 99%

Simultaneous ipsilateral nephrectomy during kidney transplantation in autosomal dominant polycystic kidney disease: a matched pair analysis of 193 consecutive cases

Jänigen

Hempel

Holzner

et al. 2020

Langenbecks Arch Surg

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Background In end-stage renal transplant recipients with autosomal-dominant polycystic kidney disease (ADPKD), the imperative, optimal timing, and technique of native nephrectomy remains under discussion. The Freiburg Transplant Center routinely performs a simultaneous ipsilateral nephrectomy. Methods From April 1998 to May 2017, we retrospectively analyzed 193 consecutive ADPKD recipients, receiving per protocol simultaneous ipsilateral nephrectomy and compared morbidity, mortality, and outcome with 193 non-ADPKD recipients of a matched pair control. Results The incidence of surgical complications was similar with respect to severe medical, surgical, urological, vascular, and wound-related complications as well as reoperation rates and 30-day mortality. Intraoperative blood transfusions were required more often in the ADPKD (22.8%) compared with the control group (6.7%; p < 0.0001). Early postoperative urinary tract infections occurred more frequent (ADPKD 40.4%/control 29.0%; p = 0.0246). Time of surgery was prolonged by 30 min (ADPKD 169 min; 95%CI 159.8-175.6 min/control 139 min; 95%CI 131.4-145.0 min; p < 0.0001). One-year patient (ADPKD 96.4%/control 95.8%; p = 0.6537) and death-censored graft survival (ADPKD 94.8%/control 93.7%; p = 0.5479) were comparable between both groups. Conclusions With respect to morbidity and mortality, per protocol, simultaneous native nephrectomy is a safe procedure. Especially in asymptomatic ADPKD KTx recipients, the number of total operations can be reduced and residual diuresis preserved up until transplantation. In living donation, even preemptive transplantation is possible.

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“…На терминальной стадии хронической почечной недостаточности поддерживаются гемодинамиче ские, экскреторные и эндокринные функции. В исследованиях приходят к выводу, что билатеральная нефрэктомия, как отдельный вид оперативного вмешательства перед трансплантацией почки, имеет значительный риск смертности и заболеваемости и не является методом выбора у пациентов, имеющих ДНМП с большой емкостью мочевого пузыря [22,23], но при этом одномоментная трансплантация почки с двусторонней нефрэктомией имеет более высокий уровень урологических осложнений, кровопотери и необходимости переливания крови, чем двусторонняя нефрэктомия в качестве первого этапа [24,25].…”

Section: Discussionunclassified

Simultaneous laparoscopic bilateral nephroureterectomy, cadaveric kidney allotransplantation and performance of vesicostomy in a patient with neurogenic bladder

Арзуманов

Chuchina

Митиш

et al. 2020

RJTAO

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We present a case of simultaneous laparoscopic bilateral nephroureterectomy, cadaveric kidney allotransplantation and performance of vesicostomy. This observation shows that patients with end-stage kidney disease, primarily caused by neurogenic bladder dysfunction, can be successfully treated via surgery. The course of early postoperative period and further rehabilitation did not differ significantly from that obtainable after standard kidney allotransplantation.

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

Cited by 30 publications

References 30 publications

Pretransplant Nephrectomy for Large Polycystic Kidneys in ADPKD (Autosomal Dominant Polycystic Kidney Disease) Patients: Is Peritoneal Dialysis Recovery Possible after Surgery?

Pretransplant Nephrectomy for Large Polycystic Kidneys in ADPKD (Autosomal Dominant Polycystic Kidney Disease) Patients: Is Peritoneal Dialysis Recovery Possible after Surgery?

Simultaneous ipsilateral nephrectomy during kidney transplantation in autosomal dominant polycystic kidney disease: a matched pair analysis of 193 consecutive cases

Simultaneous laparoscopic bilateral nephroureterectomy, cadaveric kidney allotransplantation and performance of vesicostomy in a patient with neurogenic bladder

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