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Open AccessArticle

Native Nephrectomy before and after Renal Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD)

1
Department of Urology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
2
Department of Anesthesiology and Operative Intensive Care Medicine, Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
3
Department of Nephrology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
4
Department of Urology, Heinrich-Heine-University, 40225 Düsseldorf, Germany
*
Author to whom correspondence should be addressed.
Contributed equally.
J. Clin. Med. 2019, 8(10), 1622; https://doi.org/10.3390/jcm8101622
Received: 13 August 2019 / Revised: 25 September 2019 / Accepted: 27 September 2019 / Published: 4 October 2019
(This article belongs to the Special Issue Recent Advances and Clinical Outcomes of Kidney Transplantation)
The aim of this study was 1) to evaluate and compare pre-, peri-, and post-operative data of Autosomal Dominant Polycystic Kidney Disease (ADPKD) patients undergoing native nephrectomy (NN) either before or after renal transplantation and 2) to identify advantages of optimal surgical timing, postoperative outcomes, and economical aspects in a tertiary transplant centre. This retrospective analysis included 121 patients divided into two groups—group 1: patients who underwent NN prior to receiving a kidney transplant (n = 89) and group 2: patients who underwent NN post-transplant (n = 32). Data analysis was performed according to demographic patient details, surgical indication, laboratory parameters, perioperative complications, underlying pathology, and associated mortality. There was no significant difference in patient demographics between the groups, however right-sided nephrectomy was performed predominantly within group 1. The main indication in both groups undergoing a nephrectomy was pain. Patients among group 2 had no postoperative kidney failure and a significantly shorter hospital stay. Higher rates of more severe complications were observed in group 1, even though this was not statistically significant. Even though the differences between both groups were substantial, the time of NN prior or post-transplant does not seem to affect short-term and long-term transplantation outcomes. Retroperitoneal NN remains a low risk treatment option in patients with symptomatic ADPKD and can be performed either pre- or post-kidney transplantation depending on patients’ symptom severity. View Full-Text
Keywords: ADPKD; native nephrectomy; kidney transplantation; patient outcome; perioperative complications ADPKD; native nephrectomy; kidney transplantation; patient outcome; perioperative complications
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Maxeiner, A.; Bichmann, A.; Oberländer, N.; El-Bandar, N.; Sugünes, N.; Ralla, B.; Biernath, N.; Liefeldt, L.; Budde, K.; Giessing, M.; Schlomm, T.; Friedersdorff, F. Native Nephrectomy before and after Renal Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD). J. Clin. Med. 2019, 8, 1622.

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