Simultaneous native nephrectomy with renal transplantation: Our experience and a brief literature review

Abstract

Objective: There is a need for native kidney nephrectomy to increase renal transplant surgery’s safety or improve postoperative function in some cases. The timing of the procedure is still controversial. This study aimed to present our native nephrectomy procedures performed simultaneously with the transplantation in light of the literature. Material and Methods: A retrospective analysis was performed on the data of 245 patients who underwent renal transplantation due to end-stage renal failure (ESRD) between September 2011 and February 2020. Patients who underwent unilateral or bilateral nephrectomy simultaneously with transplantation were included. Demographic characteristics of the patients, preoperative and postoperative laboratory data, primary disease, presence of comorbid diseases, duration of dialysis, duration of vascular anastomosis, surgical and clinical complications, duration of hospital stay, and graft functions were recorded.  Results: 12 patients underwent ipsilateral or bilateral native nephrectomy simultaneously with renal transplantation. The primary diseases of the patients leading to ESRD were as follows; 6 (50%) patients with Polycystic Kidney Disease (PKD), 5 (41.6%) patients with vesicoureteral reflux (VUR), one (8.3%) patient with kidney stones. Postoperative fever in three patients, erythrocyte replacement therapy in three patients, urosepsis and urinary drainage catheter requirement in one patient due to lymphocele was recorded. Two patients developed humoral rejection, and two patients developed BK virus nephropathy. Conclusion: In the presence of appropriate indications, simultaneous native nephrectomy is a safe and effective method in patients preparing for renal transplantation. In centers with sufficient experience and equipment, it may be preferable to perform native nephrectomy simultaneously with renal transplantation. Keywords: Kidney transplantation, nephrectomy, bilateral nephrectomy, polycystic kidney disease, complications.