Timing of Nephrectomy and Renal Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) in the Era of Living Kidney Donation
| Autor: | Hwai-Ding Lam, Dorottya K. de Vries, Koen E. A. van der Bogt, Andrzej Baranski, Andries E. Braat, Ian P.J. Alwayn, W. N. Nijboer, J. Nieuwenhuizen, A. F. Schaapherder, Volkert A L Huurman, Jeroen Dubbeld, Rand T. S. Alkaissy |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Kidney
medicine.medical_specialty business.industry Mortality rate medicine.medical_treatment 030232 urology & nephrology Autosomal dominant polycystic kidney disease 030230 surgery medicine.disease Nephrectomy Surgery Transplantation polycystic kidney autosomal dominant renal transplant nephrectomy 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Medicine business Complication Kidney transplantation Bilateral Nephrectomy |
| Zdroj: | Transplantology; Volume 1; Issue 1; Pages: 43-54 |
| ISSN: | 2673-3943 |
| DOI: | 10.3390/transplantology1010005 |
| Popis: | Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary disorders. Once progressed to end-stage renal disease, kidney transplantation may be needed. Whether and when to perform a (bilateral) native nephrectomy in case of end-stage renal failure are issues under debate. At our institution, with a growing number of living kidney donations, the general trend is to perform a native nephrectomy prior to transplantation. Our aim was to compare the outcomes of this approach to a nephrectomy during or after transplantation and to compare our findings to results reported in the literature. Data were prospectively collected from all ADPKD patients undergoing native nephrectomy and kidney transplantation at the Leiden University Medical Center between 2000–2017. A literature search was performed in the PubMed and Scopus databases. The clinical results were retrospectively reviewed and were stratified according to the timing of the nephrectomy. From the literature review, the most practiced approach was a combined unilateral nephrectomy and kidney transplantation. However, in our series, the favored approach was to perform a scheduled bilateral nephrectomy prior to kidney transplantation. A total of 114 patients underwent a native nephrectomy prior to (group 1, n = 85), during (group 2, n = 5), or after (group 3, n = 24) kidney transplantation. There were no statistically significant differences in postoperative morbidity after nephrectomy nor differences in kidney transplant outcome. Bilateral nephrectomy prior to kidney transplantation is a safe, controlled approach carrying minimal complication and mortality rates and facilitating a subsequent transplant procedure without mechanical or hemodynamic limitations for the graft. |
| Databáze: | OpenAIRE |
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