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

• Main Authors: Andreas Maxeiner, Anna Bichmann, Natalie Oberländer, Nasrin El-Bandar, Nesrin Sugünes, Bernhard Ralla, Nadine Biernath, Lutz Liefeldt, Klemens Budde, Markus Giessing, Thorsten Schlomm, Frank Friedersdorff
• Format: Article
• Language: English
• Published: MDPI AG 2019-10-01
• Series: Journal of Clinical Medicine
• Subjects: adpkd; native nephrectomy; kidney transplantation; patient outcome; perioperative complications
• Online Access: https://www.mdpi.com/2077-0383/8/10/1622

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&#8212;group 1: patients who underwent NN prior to receiving a kidney transplant (<i>n</i> = 89) and group 2: patients who underwent NN post-transplant (<i>n</i> = 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&#8217; symptom severity.