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Original Research

Simultaneous native nephrectomy with renal transplantation: Our experience and a brief literature review


1  University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Department of Urology, Istanbul, Turkey
2 Arnavutköy State Hospital, Department of Urology, Istanbul, Turkey

ABSTRACT

Objective: There is a need for native kidney nephrectomy to increase renal transplant surgery’s safety or improve postoperative function in some cases. The timing of the procedure is still contro-versial. This study aimed to present our native ne-phrectomy procedures performed simultaneously with the transplantation in light of the literature.

Material and Methods: A retrospective anal-ysis was performed on the data of 245 patients who underwent renal transplantation due to end-stage renal failure (ESRD) between September 2011 and February 2020. Patients who underwent uni-lateral or bilateral nephrectomy simultaneously with transplantation were included. Demographic characteristics of the patients, preoperative and postoperative laboratory data, primary disease, presence of comorbid diseases, duration of dialy-sis, duration of vascular anastomosis, surgical and clinical complications, duration of hospital stay, and graft functions were recorded. 

Results: 12 patients underwent ipsilateral or bilateral native nephrectomy simultaneously with renal transplantation. The primary diseases of the patients leading to ESRD were as follows; 6 (50%) patients with Polycystic Kidney Disease (PKD), 5 (41.6%) patients with vesicoureteral reflux (VUR), one (8.3%) patient with kidney stones. Postoper-ative fever in three patients, erythrocyte replace-ment therapy in three patients, urosepsis and uri-nary drainage catheter requirement in one patient due to lymphocele was recorded. Two patients developed humoral rejection, and two patients de-veloped BK virus nephropathy. Conclusion: In the presence of appropriate indications, simul-taneous native nephrectomy is a safe and effective method in pa-tients preparing for renal transplantation. In centers with sufficient experience and equipment, it may be preferable to perform native nephrectomy simultaneously with renal transplantation.

Keywords: Kidney transplantation, nephrectomy, bilateral ne-phrectomy, polycystic kidney disease, complications.


ABSTRACT

Objective: There is a need for native kidney nephrectomy to increase renal transplant surgery’s safety or improve postoperative function in some cases. The timing of the procedure is still contro-versial. This study aimed to present our native ne-phrectomy procedures performed simultaneously with the transplantation in light of the literature.

Material and Methods: A retrospective anal-ysis was performed on the data of 245 patients who underwent renal transplantation due to end-stage renal failure (ESRD) between September 2011 and February 2020. Patients who underwent uni-lateral or bilateral nephrectomy simultaneously with transplantation were included. Demographic characteristics of the patients, preoperative and postoperative laboratory data, primary disease, presence of comorbid diseases, duration of dialy-sis, duration of vascular anastomosis, surgical and clinical complications, duration of hospital stay, and graft functions were recorded. 

Results: 12 patients underwent ipsilateral or bilateral native nephrectomy simultaneously with renal transplantation. The primary diseases of the patients leading to ESRD were as follows; 6 (50%) patients with Polycystic Kidney Disease (PKD), 5 (41.6%) patients with vesicoureteral reflux (VUR), one (8.3%) patient with kidney stones. Postoper-ative fever in three patients, erythrocyte replace-ment therapy in three patients, urosepsis and uri-nary drainage catheter requirement in one patient due to lymphocele was recorded. Two patients developed humoral rejection, and two patients de-veloped BK virus nephropathy. Conclusion: In the presence of appropriate indications, simul-taneous native nephrectomy is a safe and effective method in pa-tients preparing for renal transplantation. In centers with sufficient experience and equipment, it may be preferable to perform native nephrectomy simultaneously with renal transplantation.

Keywords: Kidney transplantation, nephrectomy, bilateral ne-phrectomy, polycystic kidney disease, complications.

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