Timing of Nephrectomy and Renal Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) in the Era of Living Kidney Donation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Clinical Data
2.2. Literature
2.3. Physical Examination and Imaging
2.4. Surgical Technique
2.5. Statistics
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
Appendix A. Search Strategy
Component | PICO |
Patient/Population | Patient with autosomal dominant polycystic kidney disease (ADPKD) |
Intervention | native nephrectomy AND renal transplantation |
Comparison/Control | no nephrectomy AND renal transplantation |
Outcome | graft survival, complications |
References
- Tyson, M.D.; Wisenbaugh, E.S.; Andrews, P.E.; Castle, E.P.; Humphreys, M.R. Simultaneous kidney transplantation and bilateral native nephrectomy for polycystic kidney disease. J. Urol. 2013, 190, 2170–2174. [Google Scholar] [CrossRef]
- Rozanski, J.; Kozlowska, I.; Myslak, M.; Domanski, L.; Sienko, J.; Ciechanowski, K.; Ostrowski, M. Pretransplant nephrectomy in patients with autosomal dominant polycystic kidney disease. Transpl. Proc. 2005, 37, 666–668. [Google Scholar] [CrossRef]
- Schievink, W.I.; Torres, V.E.; Piepgras, D.G.; Wiebers, D.O. Saccular intracranial aneurysms in autosomal dominant polycystic kidney disease. J. Am. Soc. Nephrol. 1992, 3, 88–95. [Google Scholar]
- Gabow, P.A. Autosomal dominant polycystic kidney disease. N. Engl. J. Med. 1993, 329, 332–342. [Google Scholar] [CrossRef]
- Sulikowski, T.; Tejchman, K.; Zietek, Z.; Rozanski, J.; Domanski, L.; Kaminski, M.; Sienko, J.; Romanowski, M.; Nowacki, M.; Pabisiak, K.; et al. Experience with autosomal dominant polycystic kidney disease in patients before and after renal transplantation: A 7-year observation. Transpl. Proc. 2009, 41, 177–180. [Google Scholar] [CrossRef]
- Fuller, T.F.; Brennan, T.V.; Feng, S.; Kang, S.M.; Stock, P.G.; Freise, C.E. End stage polycystic kidney disease: Indications and timing of native nephrectomy relative to kidney transplantation. J. Urol. 2005, 174, 2284–2288. [Google Scholar] [CrossRef]
- Nunes, P.; Mota, A.; Alves, R.; Figueiredo, A.; Parada, B.; Macario, F.; Rolo, F. Simultaneous renal transplantation and native nephrectomy in patients with autosomal-dominant polycystic kidney disease. Transpl. Proc. 2007, 39, 2483–2485. [Google Scholar] [CrossRef]
- Europe Co. International Figures on Donation and Transplantation. Transpl. Newsl. 2017, 22, 40. [Google Scholar]
- Bailey, P.; Edwards, A.; Courtney, A.E. Living kidney donation. BMJ 2016, 354, i4746. [Google Scholar] [CrossRef] [Green Version]
- von Elm, E.A.D.; Egger, M.; Pocock, S.J.; Gotzsche, P.C.; Vandenbroucke, J.P. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies. Ann. Int. Med. 2007, 147, 573–577. [Google Scholar] [CrossRef] [Green Version]
- Kirkman, M.A.; van Dellen, D.; Mehra, S.; Campbell, B.A.; Tavakoli, A.; Pararajasingam, R.; Parrott, N.R.; Riad, H.N.; McWilliam, L. Native nephrectomy for autosomal dominant polycystic kidney disease: Before or after kidney transplantation? BJU Int. 2011, 108, 590–594. [Google Scholar] [CrossRef]
- Wagner, M.D.; Prather, J.C.; Barry, J.M. Selective, concurrent bilateral nephrectomies at renal transplantation for autosomal dominant polycystic kidney disease. J. Urol. 2007, 177, 2250–2254. [Google Scholar] [CrossRef]
- Kramer, A.; Sausville, J.; Haririan, A.; Bartlett, S.; Cooper, M.; Phelan, M. Simultaneous bilateral native nephrectomy and living donor renal transplantation are successful for polycystic kidney disease: The University of Maryland experience. J. Urol. 2009, 181, 724–728. [Google Scholar] [CrossRef]
- Skauby, M.H.; Oyen, O.; Hartman, A.; Leivestad, T.; Wadstrom, J. Kidney transplantation with and without simultaneous bilateral native nephrectomy in patients with polycystic kidney disease: A comparative retrospective study. Transplantation 2012, 94, 383–388. [Google Scholar] [CrossRef]
- Ahmad, S.B.; Inouye, B.; Phelan, M.S.; Kramer, A.C.; Sulek, J.; Weir, M.R.; Barth, R.N.; LaMattina, J.C.; Schweitzer, E.J.; Leeser, D.B. Live Donor Renal Transplant With Simultaneous Bilateral Nephrectomy for Autosomal Dominant Polycystic Kidney Disease Is Feasible and Satisfactory at Long-term Follow-up. Transplantation 2016, 100, 407–415. [Google Scholar] [CrossRef]
- Song, W.L.; Zheng, J.M.; Mo, C.B.; Wang, Z.P.; Fu, Y.X.; Feng, G.; Shen, Z.Y. Kidney transplant for autosomal dominant polycystic kidney disease: The superiority of concurrent bilateral nephrectomy. Urol. Int. 2011, 87, 54–58. [Google Scholar] [CrossRef]
- Glassman, D.T.; Nipkow, L.; Bartlett, S.T.; Jacobs, S.C. Bilateral nephrectomy with concomitant renal graft transplantation for autosomal dominant polycystic kidney disease. J. Urol. 2000, 164, 661–664. [Google Scholar] [CrossRef]
- Veroux, M.; Zerbo, D.; Basile, G.; Gozzo, C.; Sinagra, N.; Giaquinta, A.; Sanfiorenzo, A.; Veroux, P. Simultaneous Native Nephrectomy and Kidney Transplantation in Patients With Autosomal Dominant Polycystic Kidney Disease. PLoS ONE 2016, 11, e0155481. [Google Scholar] [CrossRef]
- Chebib, F.T.; Prieto, M.; Jung, Y.; Irazabal, M.V.; Kremers, W.K.; Dean, P.G.; Rea, D.J.; Cosio, F.G.; Torres, V.E.; El-Zoghby, Z.M. Native Nephrectomy in Renal Transplant Recipients with Autosomal Dominant Polycystic Kidney Disease. Transpl. Direct. 2015, 1, e43. [Google Scholar] [CrossRef]
- Neeff, H.P.; Pisarski, P.; Tittelbach-Helmrich, D.; Karajanev, K.; Neumann, H.P.; Hopt, U.T.; Drognitz, O. One hundred consecutive kidney transplantations with simultaneous ipsilateral nephrectomy in patients with autosomal dominant polycystic kidney disease. Nephrol. Dial. Transpl. 2013, 28, 466–471. [Google Scholar] [CrossRef] [Green Version]
- Garcia-Rubio, J.H.; Valiente, J.C.; Hernandez, J.P.C.; Garcia, J.R.; Lopez, J.M.; Lopez, J.C.R.; Castineira, R.C.; de Mier, M.V.P.R.; Tapia, M.J.R. Graft Survival in Patients With Polycystic Kidney Disease With Nephrectomy of Native Kidney Pretransplant. Transpl. Proc. 2015, 47, 2615–2617. [Google Scholar] [CrossRef]
- Katznelson, S.; Bhaduri, S.; Cecka, J.M. Clinical aspects of sensitization. Clin. Transpl. 1997, 11, 285–296. [Google Scholar]
- Hajj, P.; Ferlicot, S.; Massoud, W.; Awad, A.; Hammoudi, Y.; Charpentier, B.; Durrbach, A.; Droupy, S.; Benoit, G. Prevalence of renal cell carcinoma in patients with autosomal dominant polycystic kidney disease and chronic renal failure. Urology 2009, 74, 631–634. [Google Scholar] [CrossRef]
- Tonelli, M.; Wiebe, N.; Knoll, G.; Bello, A.; Browne, S.; Jadhav, D.; Klarenbach, S.; Gill, J. Systematic review: Kidney transplantation compared with dialysis in clinically relevant outcomes. Am. J. Transpl. 2011, 11, 2093–2109. [Google Scholar] [CrossRef]
- Wolfe, R.A.; Ashby, V.B.; Milford, E.L.; Ojo, A.O.; Ettenger, R.E.; Agodoa, L.Y.; Held, P.J.; Port, F.K. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N. Engl. J. Med. 1999, 341, 1725–1730. [Google Scholar] [CrossRef] [Green Version]
- Spithoven, E.M.; Kramer, A.; Meijer, E.; Orskov, B.; Wanner, C.; Abad, J.M.; Areste, N.; de la Torre, R.A.; Caskey, F.; Couchoud, C.; et al. Renal replacement therapy for autosomal dominant polycystic kidney disease (ADPKD) in Europe: Prevalence and survival—An analysis of data from the ERA-EDTA Registry. Nephrol. Dial. Transpl. 2014, 29, iv15–iv25. [Google Scholar] [CrossRef] [Green Version]
- Patel, P.; Horsfield, C.; Compton, F.; Taylor, J.; Koffman, G.; Olsburgh, J. Native nephrectomy in transplant patients with autosomal dominant polycystic kidney disease. Ann. R. Coll. Surg. Engl. 2011, 93, 391–395. [Google Scholar] [CrossRef] [Green Version]
- Cornelis, F.; Couzi, L.; Le Bras, Y.; Hubrecht, R.; Dodre, E.; Genevieve, M.; Perot, V.; Wallerand, H.; Ferriere, J.M.; Merville, P.; et al. Embolization of polycystic kidneys as an alternative to nephrectomy before renal transplantation: A pilot study. Am. J. Transpl. 2010, 10, 2363–2369. [Google Scholar] [CrossRef]
- Suwabe, T.; Ubara, Y.; Sekine, A.; Ueno, T.; Yamanouchi, M.; Hayami, N.; Hoshino, J.; Kawada, M.; Hiramatsu, R.; Hasegawa, E.; et al. Effect of renal transcatheter arterial embolization on quality of life in patients with autosomal dominant polycystic kidney disease. Nephrol. Dial. Transpl. 2017, 32, 1176–1183. [Google Scholar] [CrossRef] [Green Version]
- Millar, M.; Tanagho, Y.S.; Haseebuddin, M.; Clayman, R.V.; Bhayani, S.B.; Figenshau, R.S. Surgical cyst decortication in autosomal dominant polycystic kidney disease. J. Endourol. 2013, 27, 528–534. [Google Scholar] [CrossRef] [Green Version]
- Torres, V.E.; Chapman, A.B.; Devuyst, O.; Gansevoort, R.T.; Grantham, J.J.; Higashihara, E.; Perrone, R.D.; Krasa, H.B.; Ouyang, J.; Czerwiec, F.S. Tolvaptan in patients with autosomal dominant polycystic kidney disease. N. Engl. J. Med. 2012, 367, 2407–2418. [Google Scholar] [CrossRef] [Green Version]
- Gurung, P.M.S.; Frye, T.P.; Rashid, H.H.; Joseph, J.V.; Wu, G. Robot-assisted Synchronous Bilateral Nephrectomy for Autosomal Dominant Polycystic Kidney Disease: A Stepwise Description of Technique. Urology 2020. [Google Scholar] [CrossRef]
Group 1 n = 85 | Group 2 n = 5 | Group 3 n = 24 | Total n = 114 | p-Value | |
---|---|---|---|---|---|
Sex | |||||
| 51 (60.0%) | 4 (80.0%) | 14 (58.3%) | 69 (60.5%) | 0.673 |
| 34 (40.0%) | 1 (20.0%) | 10 (41.7%) | 45 (39.5%) | |
Age (SD) | 52.7 (9.8) | 57.6 (9.8) | 58.1 (9.9) | 54.1 (10.0) | 0.035 |
BMI (SD) | 25.5 (3.8) | 27.7 (4.4) | 25.2 (3.3) | 25.6 (3.7) | 0.351 |
Dialysis | 53(62.4%) | 5 (100%) | 6 (25%) | 64 (56.1%) | 0.009 |
Nephrectomy | |||||
| 12 (14.1%) | 4 (80.0%) | 4 (16.7%) | 20 (17.5%) | 0.043 |
| 73 (85.9%) | 1 (20.0%) | 20 (83.3%) | 94 (82.5%) | |
| 58 (68.2%) | 2 (40.0%) | 15 (62.5%) | 75 (65.8%) | 0.430 |
| 27 (31.8%) | 3 (60.0%) | 9 (37.5%) | 39 (34.2%) |
Group 1 (n = 85) | Group 2 (n = 5) | Group 3 (n = 24) | Total (n = 114) | |
---|---|---|---|---|
Lack of space | 72.9% | 100% | 12.5% | 61.4% |
Infection | 15.3% | 0 | 37.5% | 19.2% |
Mobility | 9.4% | 0 | 45.8% | 16.7% |
Other | 2.4% | 0 | 4.2% | 2.6% |
Group 1 (n = 85) | Group 2 (n = 5) | Group 3 (n = 24) | Missing (%) | p-Value | |
---|---|---|---|---|---|
Weight native kidney (kg) | 0 | ||||
- Left (SD) | 2.5 (1.5) | 2.8 (0.0) | 1.9 (1.3) | 0.205 | |
- Right (SD) | 2.5 (1.5) | 3.6 (1.8) | 1.7 (1.2) | 0.010 | |
Blood loss (L) | 0.71 (0.63) | 0.76 (0.47) | 0.63(0.40) | 10.5% | 0.809 |
Blood transfusion units (SD) | 1.06 (2.63) | 0.60 (1.34) | 1.67 (2.44) | 0 | 0.510 |
Hospital stay in days (SD) | 9.45 (7.17) | 8.40 (2.51) | 10.08 (7.03) | 0 | 0.862 |
Hb | 6.1% | ||||
- pre (SD) | 7.60 (1.18) | 8.40 (0.95) | 7.72 (1.47) | 0.338 | |
- post (SD) | 5.74 (1.02) | 6.22 (0.97) | 6.29 (1.26) | 0.089 | |
Operation time in min (SD) | 169 (48.1) | 207 (25.8) | 158 (173.8) | 0 | 0.096 |
Diuresis (L/24 h) | |||||
- before NN | 1.53 (0.76) | 1.14 (0.93) | 1.59 (0.73) | 0 | 0.494 |
- after UNN 1 | 0.13 (0.36) | 0.97 (1.01) | 1.38 (0.88) | 40.0% | 0.000 |
Complications | 36 (42.4%) | 1 (20.0%) | 7 (29.2%) | 0 | 0.699 |
- hypotension | 21 | 1 | 2 | ||
- incisional hernia | 4 | 0 | 1 | ||
- shunt occlusion | 4 | 0 | 0 | ||
- other | 7 | 0 | 4 |
LKD (n = 75) | DKD (n = 39) | Missing (%) | p-Value | |
---|---|---|---|---|
Blood loss in L (SD) | 0.63 (0.42) | 0.82 (0.78) | 10.5% | 0.101 |
Blood transfusion units (SD) | 0.95 (2.44) | 1.59 (2.73) | 0 | 0.197 |
Hospital stay in days (SD) | 9.05 (6.43) | 10.46 (7.92) | 0 | 0.302 |
Hb | ||||
- Pre (SD) | 7.56 (1.28) | 7.82 (1.13) | 6.1% | 0.295 |
- Post (SD) | 5.84 (1.10) | 5.94 (1.07) | 0.648 | |
Operation time in mins (SD) | 168 (43.2) | 170 (54.9) | 0 | 0.841 |
Diuresis (L/24 h) 1 | ||||
- Before | 1.68 (0.64) | 1.18 (0.89) | 20.5% | 0.002 |
- After | 0.35 (0.71) | 0.28 (0.52) | 0.607 | |
Dialysis | 30 (40.0%) | 34 (87.2%) | 0 | 0.000 |
Complications | 29 (38.7%) | 15 (38.5%) | 0 | 1.000 |
- Hypotension | 17 | 7 | ||
- Incisional hernia | 5 | 0 | ||
- Shunt occlusion | 1 | 3 | ||
- Other | 6 | 5 |
Study | Years (No.) | Patients (No.) | Blood Loss (mL) | Blood Transfusions (units) | Hospital Stay (days) | OR Time (min) | Graft dysfunction 1 (No.) | Complication Rate 4,5 | Mortality (No.) |
---|---|---|---|---|---|---|---|---|---|
Kirkman [11] | 6 | 35 | - | - | - | - | 2 (5.7%) | 3 (8.6%) | |
| 20 (57.1%) | - | 0 | - | - | 0 | 35.0% | 2 (10%) | |
| 3 (8.6%) | - | - | - | - | 0 | 0 | 0 | |
| 12 (34.3%) | - | - | - | - | 2 (20%) | 50.0% | 1 (10%) | |
Sulikowski [5] | 7 | 50 | - | - | - | - | 5 (10%) | 1 (2%) | |
| 25 (50%) | - | - | - | - | 1 (20%) | 56.5% | 0 | |
| 4 (8%) | - | - | - | - | 0 | 25.0% | 0 | |
| 21 (42%) | - | - | - | - | 4 (19%) | 90.5% | 1 (4.8%) | |
Wagner [12] | 5 | 32 | - | - | - | - | - | - | |
| 15 (46.9%) | 651 | 1.2 | 11.8 | 252 | - | 73.3% | - | |
| 17 (53.1%) | 617 | 2.2 | 6.9 | 430 | - | 70.6% | - | |
Fuller [6] | 10 | 32 | - | - | - | - | - | 1 (3.1%) | |
| 7 (21.9%) | 530 | - | 7 | 231 | - | 14.3% | 0 | |
| 16 (50%) | 570 | 2 3 | 8.6 | 370 | - | 0 | 0 | |
| 9 (28.1%) | 520 | - | 6.3 | 208 | - | 11.1% | 1 (11.1%) | |
Kramer [13] | 4 | 20 | 724 | 3.3 | 7.2 | 391 | 0 | 20.0% | 0 |
Nunes [7] | 25 | 159 | - | - | - | - | 99 (62.3%) | - | |
| 16 (10%) | - | 1.81 | 16.5 | 254 | 12 (74.4%) | 87.0% | - | |
| 143 (90%) | - | 1.05 | 12.7 | 181 | 87 (61.2%) | 76.2% | - | |
Skauby [14] | 19 | 157 | - | - | - | - | 2 (1.3%) | - | |
| 78 (49.7%) | - | 1.6 | 15.4 | 319.3 | 1 (1.3%) | 30.8% | - | |
| 79 (50.3%) | - | 0.1 | 11.4 | 183.7 | 1 (1.3%) | 26.6% | - | |
Ahmad [15] | 10 | 118 | - | - | - | - | 12 (10.2%) | 0 | |
| 66 (55.9%) | 1251 | 3.4 | 6.6 | 381 | 4 (6.1%) | 71.2% | 0 | |
| 52 (44.1%) | 425 | 0.46 | 4.8 | 204 | 8 (15.4%) | 59.6% | 0 | |
Song [16] | 9 | 63 | - | - | - | - | 10 (15.9%) | - | |
| 31 (49.2%) | - | 4.68 | 15.38 | 280 | 6 (19.4%) | 80.6% | - | |
| 32 (50.8%) | - | 2.03 | 14.25 | 141 | 4 (12.5%) | 53.1% | - | |
Glassman [17] | 3 | 23 | - | - | - | - | 2 (8.7%) | 0 | |
| 4 (17.4%) | 650 | 0 | 13.3 | 403.8 | 1 (25%) | 50.0% | 0 | |
| 10 (43.5%) | 1454.2 | 2.3 | 7.6 | 452.5 | 0 | 88.9% | 0 | |
| 9 (39.1%) | 344 | 1.0 | 7.1 | 295.6 | 1 (11.1%) | 75.0% | 0 | |
Veroux [18] | 15 | 145 | - | - | - | - | 49 (33.8%) | 1 (0.7%) | |
| 25 (17.2%) | 421 | - | 15.4 | 421 | 11 (44%) | 20.0% | 0 | |
| 40 (27.5%) | 300 | - | 13.3 | 300 | 10 (25%) | 10.0% | 0 | |
| 80 (55.2%) | 522 | - | 16.5 | 522 | 28 (35%) | 15.0% | 1 (1.25%) | |
Current study | 17 | 114 | 698 | 1.17 | 11.4 | 168.9 | - | 1 (0.9%) | |
| 85 (74.6%) | 714 | 1.06 | 9.45 | 169.5 | - | 42.4% | 0 | |
| 5 (4.4%) | 755 | 0.60 | 8.40 | 207.4 | - | 20.0% | 0 | |
| 24 (21.1%) | 628 | 1.67 | 10.1 | 158.6 | - | 29.2% | 1 (4.2%) |
Advantage | Disadvantage | |
---|---|---|
Pre-transplantation nephrectomy | Reduced risk of infection Reduced risk of malignancies Mechanical relief for patient Create space for graft kidney | Increased risk of graft rejection in case of transfusion Anuric state of patient Necessity for dialysis |
Peri-transplantation nephrectomy | Single procedure No temporary hemodialysis No anuric state of patient | Longer procedure Possibly higher blood loss |
Post-transplantation nephrectomy | Preservation of diuresis No temporary hemodialysis Preservation of diuresis | Increased risk of infection due to immunosuppression Increased risk of malignant developments Mechanical compression of graft kidney |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Alkaissy, R.T.S.; Schaapherder, A.F.M.; Baranski, A.G.; Dubbeld, J.; Braat, A.E.; Lam, H.-D.; Nijboer, W.N.; Nieuwenhuizen, J.; de Vries, D.K.; Huurman, V.A.L.; et al. Timing of Nephrectomy and Renal Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) in the Era of Living Kidney Donation. Transplantology 2020, 1, 43-54. https://doi.org/10.3390/transplantology1010005
Alkaissy RTS, Schaapherder AFM, Baranski AG, Dubbeld J, Braat AE, Lam H-D, Nijboer WN, Nieuwenhuizen J, de Vries DK, Huurman VAL, et al. Timing of Nephrectomy and Renal Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) in the Era of Living Kidney Donation. Transplantology. 2020; 1(1):43-54. https://doi.org/10.3390/transplantology1010005
Chicago/Turabian StyleAlkaissy, Rand T. S., Alexander F. M. Schaapherder, Andrzej G. Baranski, J. Dubbeld, Andries E. Braat, Hwai-Ding Lam, W. N. Nijboer, J. Nieuwenhuizen, Dorottya K. de Vries, Volkert A. L. Huurman, and et al. 2020. "Timing of Nephrectomy and Renal Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) in the Era of Living Kidney Donation" Transplantology 1, no. 1: 43-54. https://doi.org/10.3390/transplantology1010005
APA StyleAlkaissy, R. T. S., Schaapherder, A. F. M., Baranski, A. G., Dubbeld, J., Braat, A. E., Lam, H.-D., Nijboer, W. N., Nieuwenhuizen, J., de Vries, D. K., Huurman, V. A. L., Alwayn, I. P. J., & van der Bogt, K. E. A. (2020). Timing of Nephrectomy and Renal Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) in the Era of Living Kidney Donation. Transplantology, 1(1), 43-54. https://doi.org/10.3390/transplantology1010005