Erythrocytosis after renal transplantation; treatment by removal of the native kidneys.
Erythrocytosis after renal transplantation confers risks of thromboembolic complications and therefore necessitates repeated phlebotomies and/or anticoagulation therapy. Erythropoietin production from the retained native kidneys is one aetiological possibility for this condition. During 1982-1987, 22 patients with renal transplants underwent bilateral nephrectomy because of erythrocytosis with a median duration of 13 months. The median follow-up time was 36 months. After nephrectomy, blood counts returned to normal in all patients; these remained normal in all but two patients, who relapsed with erythrocytosis after 6 and 18 months respectively. Concomitant hypertension was cured or improved in most cases. One patient had a myocardial infarction postoperatively. No other per- or postoperative complications occurred. The mean duration of hospital stay was 7.5 days. We consider bilateral nephrectomy of the native kidneys a safe and effective alternative in the management of post-transplant erythrocytosis.
Friman
S
S
Department of Surgery, Sahlgrenska Hospital, Göteborg, Sweden.
Nyberg
G
G
Blohmé
I
I
D000328:Adult; D002648:Child; D004921:Erythropoietin / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D009392:Nephrectomy; D011086:Polycythemia / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation
D006454:Hemoglobins; D004921:Erythropoietin