Native Nephrectomy in Renal Transplant Recipients With Autosomal Dominant Polycystic Kidney Disease

• Published in: Transplantation proceedings Vol. 50; no. 6; pp. 1863 - 1867
• Main Authors: Jankowska, M., Kuźmiuk-Glembin, I., Skonieczny, P., Dębska-Ślizień, A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2018
• Subjects: Adult; Delayed Graft Function - epidemiology; Female; Graft Rejection - epidemiology; Humans; Kidney Transplantation - methods; Male; Middle Aged; Nephrectomy - methods; Polycystic Kidney, Autosomal Dominant - surgery; Retrospective Studies; Transplant Recipients; Waiting Lists
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2018.02.100

Patients with autosomal dominant polycystic kidney disease (ADPKD) represent about 10% of kidney transplant recipients (KTR) and have unique needs regarding acceptance for this procedure. Whether native kidney nephrectomy (NKN) affects kidney transplantation (KT) outcomes remains a matter of debate, and more data is needed to establish a standard approach to KTR with ADPKD. To analyze the prevalence, timing, and short- and long-term outcomes of NKN in a cohort of ADPKD recipients in a single institution. Retrospective, observational study. In the years 1993 to 2016 we identified 162 KTR with ADPKD; of those, 149 had known NKN status. A high proportion of ADPKD KTR (n = 72) underwent NKN, the majority of which (69.4%) were performed before KT. There was no difference in short-term and long-term transplantation outcomes (including death, graft loss, delayed graft function, acute rejection, bacterial and cytomegalovirus [CMV] infection, and post-transplant diabetes mellitus) between NKN and non-NKN groups in a median of 98 months of follow-up. However, we found a significant difference in time on a waiting list, which was longer in the NKN group vs non-NKN. There is a need for a consensus regarding indications and timing for NKN in recipients with ADPKD. The systematic acquisition, sharing, and analysis of accessible data on NKN between institutions is an important step toward meeting this need. In our cohort, we found no impact of the NKN procedure on KT impact. However, undergoing NKN significantly prolonged the time on the waiting list. •Native nephrectomy in ADPKD kidney transplant recipients was analyzed.•Native nephrectomy extended time from enlisting to kidney transplantation.•Outcomes of kidney transplantation were not influenced by history of nephrectomy.•Consensus on indications and timing for nephrectomy in ADPKD should be established.