Objective: The number of cases with graft failure, which is the most frequent complication of renal transplantation, is increasing due to the increasing number of kidney transplant surgeries. Graft nephrectomy is the last treatment option in renal transplant recipients with graft failure due to the high complication risk it entails. The aim of the present study is to evaluate the clinical characteris- tics, etiologies for nephrectomy, pathological anal- ysis of explanted graft, and surgical complications in recipients with graft nephrectomy.
Material and Methods: We retrospectively analyzed 38 recipients who had undergone graft nephrectomy for different reasons in the center since 2010. The recipients were divided into two groups, according to the time of surgery, with char- acteristics analyzed retrospectively. The early graft nephrectomy group consisted of patients who had undergone graft nephrectomy in the first 6 months after transplant surgery; the late graft nephrectomy group consisted of patients who had undergone graft nephrectomy more than 6 months after surgery. Results: Indications for early graft nephrectomy were mostly vascular, surgical problems, and infection, whereas indications for late graft ne- phrectomy were rejection and infection. There was a statistically significant difference between the two groups with respect to rejection. The rate of graft survival, post-operative vascular and surgical com- plications were higher in the early group (p=0.011, and p=0.005, respectively). Panel
Reactive Antibody (PRA) positivity was evaluated, and no difference was ob- served between the two groups in terms of immunological risk. Conclusions: As graft nephrectomy has high morbidity and mortality rates, it should only be applied in selected cases, where
necessary, in order to prevent potentially serious complications.
Keywords: Graft, nephrectomy, kidney, transplantation, com- plications.
ABSTRACT
Objective: The number of cases with graft failure, which is the most frequent complication of renal transplantation, is increasing due to the increasing number of kidney transplant surgeries. Graft nephrectomy is the last treatment option in renal transplant recipients with graft failure due to the high complication risk it entails. The aim of the present study is to evaluate the clinical characteris- tics, etiologies for nephrectomy, pathological anal- ysis of explanted graft, and surgical complications in recipients with graft nephrectomy.
Material and Methods: We retrospectively analyzed 38 recipients who had undergone graft nephrectomy for different reasons in the center since 2010. The recipients were divided into two groups, according to the time of surgery, with char- acteristics analyzed retrospectively. The early graft nephrectomy group consisted of patients who had undergone graft nephrectomy in the first 6 months after transplant surgery; the late graft nephrectomy group consisted of patients who had undergone graft nephrectomy more than 6 months after surgery. Results: Indications for early graft nephrectomy were mostly vascular, surgical problems, and infection, whereas indications for late graft ne- phrectomy were rejection and infection. There was a statistically significant difference between the two groups with respect to rejection. The rate of graft survival, post-operative vascular and surgical com- plications were higher in the early group (p=0.011, and p=0.005, respectively). Panel
Reactive Antibody (PRA) positivity was evaluated, and no difference was ob- served between the two groups in terms of immunological risk. Conclusions: As graft nephrectomy has high morbidity and mortality rates, it should only be applied in selected cases, where
necessary, in order to prevent potentially serious complications.
Keywords: Graft, nephrectomy, kidney, transplantation, com- plications.