Published online May 18, 2022. doi: 10.5500/wjt.v12.i5.100
Peer-review started: March 31, 2021
First decision: July 29, 2021
Revised: August 11, 2021
Accepted: April 9, 2022
Article in press: April 9, 2022
Published online: May 18, 2022
Processing time: 407 Days and 6.5 Hours
The lack of space, as an indication for a native unilateral nephrectomy for positioning a future kidney graft in the absence of other autosomal dominant polycystic kidney disease-related symptoms, remains controversial.
To evaluate the surgical comorbidity and the impact on graft survival of an associated ipsilateral native nephrectomy during isolated kidney transplantation in patients with autosomal dominant polycystic kidney disease.
One hundred and fifty-four kidney transplantations performed between January 2007 and January 2019 of which 77 without (kidney transplant alone (KTA) group) and 77 with associated ipsilateral nephrectomy (KTIN group), were re
Creation of space for future graft positioning was the main reason (n = 74, 96.1%) for associated ipsilateral nephrectomy. No significant difference in surgical comorbidity (lymphocele, wound infection, incisional hernia, wound hematoma, urinary infection, need for blood transfusion, hospitalization stay, Dindo Clavien classification and readmission rate) was observed between the two study groups. The incidence of primary nonfunction and delayed graft function was comparable in both groups [0% and 2.6% (P = 0.497) and 9.1% and 16.9% (P = 0.230), respectively, in the KTA and KTIN group]. The 1- and 5-year graft survival were 94.8% and 90.3%, and 100% and 93.8%, respectively, in the KTA and KTIN group (P = 0.774). The 1- and 5-year patient survival were 96.1% and 92.9%, and 100% and 100%, respectively, in the KTA and KTIN group (P = 0.168).
Simultaneous ipsilateral native nephrectomy to create space for graft positioning during kidney transplantation in patients with autosomal dominant polycystic kidney disease does not negatively impact surgical comorbidity and short- and long-term graft survival.
Core Tip: The associated surgical comorbidity and graft survival of an ipsilateral nephrectomy during isolated kidney transplantation in patients with autosomal dominant polycystic kidney disease was evaluated. One hundred and fifty-four patients were retrospectively evaluated, of which 77 did and 77 did not undergo associated ipsilateral nephrectomy during the transplantation. In a long-term follow-up, we observed no negative impact on surgical comorbidity and graft survival of a simultaneous ipsilateral native nephrectomy to create space for graft positioning during kidney transplantation in patients with autosomal dominant polycystic kidney disease.