Tailoring the 'Perfect Fit' for Renal Transplant Recipients with End-stage Polycystic Kidney Disease: Indications and Timing of Native Nephrectomy

Overview

Journal In Vivo

Specialty Oncology

Date 2017 Apr 26

PMID 28438856

Citations 9

Authors

Chrysoula Argyrou

Demetrios Moris

Spyridon Vernadakis

Affiliations

Soon will be listed here.

Abstract

Background: The ideal timing of native nephrectomy in relation to kidney transplantation in patients with autosomal-dominant polycystic kidney disease (ADPKD) can be a very puzzling decision for transplant surgeons and remains a matter of debate. This review article aims to present current literature regarding this highly controversial issue.

Materials And Methods: The MEDLINE/PubMed database was searched using "polycystic kidney disease", "renal/kidney transplantation" and "native nephrectomy" as key words. Our search was focused on the optimal timing of and indications for native nephrectomy in renal transplant recipients with ADPKD.

Results: In symptomatic cases, pre-transplant unilateral or bilateral native nephrectomy seems appropriate, in order to alleviate symptoms. In cases that are provided with the option of living-donor transplantation, the performance of the simultaneous procedure could be of benefit. When the principal indication of native nephrectomy is the creation of space for the renal allograft, various studies highlight the safety of the simultaneous approach of either unilateral or bilateral nephrectomy.

Conclusion: No consensus exists on the appropriate timing for native nephrectomy in patients with ADPKD. Several issues to be addressed in the decision-making process are the importance of residual diuresis, the longer operative time along with the associated prolonged ischemia time and higher complication rate of the combined procedure.

Citing Articles

Semi-simultaneous hand-assisted laparoscopic (HAL) bilateral nephrectomy and kidney transplantation from the same incision in ADPKD, first case report in Saudi Arabia.

Shaheen M, Aljehaiman F, Altheaby A J Surg Case Rep. 2024; 2024(5):rjae274.

PMID: 38706492 PMC: 11066794. DOI: 10.1093/jscr/rjae274.

Native nephrectomy in polycystic kidney disease patients on transplant lists: how and when?.

Copur S, Ozbek L, Guldan M, Topcu A, Kanbay M J Nephrol. 2024; 37(6):1463-1475.

PMID: 38512371 PMC: 11473585. DOI: 10.1007/s40620-024-01899-7.

Robotic bilateral nephrectomy for large polycystic kidney disease.

Masterson J, Zhao H, Taich L, Naser-Tavakolian A, Johnson H, Najjar R BJUI Compass. 2023; 4(6):701-708.

PMID: 37818019 PMC: 10560624. DOI: 10.1002/bco2.263.

Native nephrectomy in advanced pediatric kidney disease: indications, timing, and surgical approaches.

Crawford B, Kizilbash S, Bhatia V, Kulsum-Mecci N, Cannon S, Bartosh S Pediatr Nephrol. 2023; 39(4):1041-1052.

PMID: 37632524 DOI: 10.1007/s00467-023-06117-3.

Simultaneous nephrectomy during kidney transplantation for polycystic kidney disease does not detrimentally impact comorbidity and graft survival.

Darius T, Bertoni S, De Meyer M, Buemi A, Devresse A, Kanaan N World J Transplant. 2022; 12(5):100-111.

PMID: 35663541 PMC: 9136716. DOI: 10.5500/wjt.v12.i5.100.

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