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Removal Plus Transplant Surgery Feasible in Polycystic Kidney Disease

Simultaneous bilateral laparoscopic nephrectomy can be done at the time of living donor kidney transplant

kidney illustration

THURSDAY, Oct. 15, 2020 (HealthDay News) -- Patients with large polycystic kidneys can have their diseased kidneys safely removed laparoscopically at the same time as their kidney transplant (KT) surgery, according to a study published online Sept. 16 in the American Journal of Transplantation.

Nitin Abrol, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues compared simultaneous bilateral nephrectomy (BN) plus kidney transplantation (BNKT; 51 patients) to contemporaneous KT-only controls (97 patients) among patients with polycystic kidney disease who underwent KT from a living donor (January 2014 to October 2019).

The researchers found that patients receiving bilateral nephrectomies had increased total kidney volumes (P < 0.001). Compared with patients in the KT-only group, those in the BNKT group had longer cold ischemia time, increased care requirements in the intensive care unit, more blood transfusions, and longer hospital stays. In the first year, kidney function was similar between the groups. Additionally, there were no differences in delayed graft function, readmissions, or severe grade III and IV complications within three months of surgery.

"Although higher acuity care is needed with a longer initial hospital stay, there are comparable post-transplant patient and allograft outcomes," the authors write.

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