No Effect of Pretransplantation Bilateral Nephrectomy on the Resistive Indices Measured in the Kidney Allograft

• Published in: Transplantation proceedings Vol. 46; no. 8; pp. 2602 - 2605
• Main Authors: Kujawa-Szewieczek, A, Kolonko, A, Chudek, J, Więcek, A
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2014
• Subjects: Adult; Allografts; Female; Humans; Hypertension, Renal - epidemiology; Kidney - diagnostic imaging; Kidney - physiopathology; Kidney Transplantation; Male; Middle Aged; Nephrectomy; Preoperative Period; Surgery; Ultrasonography, Doppler; Vascular Resistance
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2014.08.029

Abstract Background The cirrhotic kidney is the cause of sympathetic nervous system and the renin-angiotensin system activation leading to increased vascular resistance and arterial hypertension. The impact of unilateral or bilateral nephrectomy (UN or BN) performed before kidney transplantation on kidney graft intrarenal resistance has not been assessed yet. The aim of this study is to assess the intrarenal resistance parameters measured by Doppler ultrasound in the transplanted kidney in either nephrectomized or non-nephrectomized kidney transplant recipients. Methods Among 686 consecutive successful first cadaveric kidney graft recipients transplanted from 1998 to 2012, we identified 43 patients who underwent BN and 49 patients who underwent UN. Patients with acute rejection episodes within an early post-transplantation period were excluded. We have analyzed both pulsatility (PI) and resistance (RI) indices measured within the kidney graft before discharge from the hospital. Results The prevalence of hypertension in the follow-up period after transplantation was significantly lower in the BN group (65.1% versus 81.0% in other groups). Neither BN nor UN influenced the PI or RI values. The mean PI and RI values were 1.50 (1.38–1.61) and 0.75 (0.73–0.78) in BN, 1.48 (1.37–1.58) and 0.76 (0.73–0.79) in UN, and 1.47 (1.43–1.50) and 0.74 (0.73–0.75) in non-nephrectomized patients, respectively. The results of multivariate analysis confirmed the lack of influence of nephrectomy on kidney graft resistive indices. Conclusion BN before transplantation resulted in lower frequency of hypertension, but it did not affect the intrarenal vascular resistance measured in the kidney graft.