Effectiveness of Nephrectomy and Transcatheter Arterial Embolization Before Kidney Transplantation in Autosomal Dominant Polycystic Kidney Disease.
Adult
Embolization, Therapeutic
/ methods
Feasibility Studies
Female
Humans
Kidney
/ blood supply
Kidney Transplantation
/ mortality
Male
Middle Aged
Nephrectomy
/ methods
Polycystic Kidney, Autosomal Dominant
/ therapy
Postoperative Complications
/ etiology
Preoperative Care
/ methods
Retrospective Studies
Survival Rate
Journal
Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532
Informations de publication
Date de publication:
Historique:
received:
24
11
2019
accepted:
02
01
2020
pubmed:
28
4
2020
medline:
15
12
2020
entrez:
28
4
2020
Statut:
ppublish
Résumé
Renal transplantation in patients with autosomal dominant polycystic kidney disease (ADPKD) remains a feasible option because no recurrence has been reported. Transcatheter arterial embolization (TAE) for patients with ADPKD is performed to control infection, pain, or bleeding and can help reduce kidney volume. However, nephrectomy may be needed for inadequate kidney shrinkage. The effects of these procedures performed before transplantation on transplant outcomes or kidney functions are not discussed. We retrospectively evaluated the effectiveness of nephrectomy and TAE before transplantation. Forty-four patients who underwent renal transplantation in our center between 2008 and 2018 were classified into 4 groups according to whether nephrectomy or TAE was performed. We collected information on sex, age, type of transplantation, history of nephrectomy or TAE, renal function, postoperative complications, graft acceptance, and survival rates. Of the 17 patients who underwent TAE and those who did not, 8 and 7 underwent nephrectomy, respectively; 16 underwent bilateral TAE and primitive transplantation. The patients who underwent both nephrectomy and TAE had significantly better kidney function than those who underwent neither. With TAE alone, without nephrectomy, the mean volume reduction rate was 23.5% and 28.4% on the left and right, respectively; in patients who underwent neither procedure, the mean volume reduction rates were 24.8% and 28.4%, respectively. Patients who underwent both nephrectomy and TAE had better renal function than those in any other group. However, if the recipient's pelvis has sufficient space, nephrectomy is unnecessary because the kidney volume decreases after transplantation by approximately 25%.
Sections du résumé
BACKGROUND
BACKGROUND
Renal transplantation in patients with autosomal dominant polycystic kidney disease (ADPKD) remains a feasible option because no recurrence has been reported. Transcatheter arterial embolization (TAE) for patients with ADPKD is performed to control infection, pain, or bleeding and can help reduce kidney volume. However, nephrectomy may be needed for inadequate kidney shrinkage. The effects of these procedures performed before transplantation on transplant outcomes or kidney functions are not discussed. We retrospectively evaluated the effectiveness of nephrectomy and TAE before transplantation.
METHODS
METHODS
Forty-four patients who underwent renal transplantation in our center between 2008 and 2018 were classified into 4 groups according to whether nephrectomy or TAE was performed. We collected information on sex, age, type of transplantation, history of nephrectomy or TAE, renal function, postoperative complications, graft acceptance, and survival rates.
RESULTS
RESULTS
Of the 17 patients who underwent TAE and those who did not, 8 and 7 underwent nephrectomy, respectively; 16 underwent bilateral TAE and primitive transplantation. The patients who underwent both nephrectomy and TAE had significantly better kidney function than those who underwent neither. With TAE alone, without nephrectomy, the mean volume reduction rate was 23.5% and 28.4% on the left and right, respectively; in patients who underwent neither procedure, the mean volume reduction rates were 24.8% and 28.4%, respectively.
CONCLUSIONS
CONCLUSIONS
Patients who underwent both nephrectomy and TAE had better renal function than those in any other group. However, if the recipient's pelvis has sufficient space, nephrectomy is unnecessary because the kidney volume decreases after transplantation by approximately 25%.
Identifiants
pubmed: 32336652
pii: S0041-1345(19)31465-4
doi: 10.1016/j.transproceed.2020.01.135
pii:
doi:
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1680-1683Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.