[Nephrectomy of the transplanted kidney].
A total of 118 allograft nephrectomies (TX) were performed after 474 renal transplants (TR) (24.9%). 49.1% of the patients were immunosuppressed with azathioprine-prednisone (AZA-PRED) and 50.9% with cyclosporine-prednisone (CSA-PRED). Mean time to TX after returning to hemodialysis was 36.2 +/- 6.4 days (0-372). Acute rejection (33.1%) was the first cause of TX, followed by chronic rejection (26.3%), vascular complications (25.5%), recurrent renal disease (5.9%), non-functioning allograft (4.2%) and not clearly established cause (1.7%). The surgical technique was extracapsular in 70.3% of the cases and subcapsular in 29.7%. The mean post-TR time to TX was significantly greater (p < 0.01) for the subcapsular technique. The mean surgical time was 106 +/- 4.4 min (45-300). Post-TX morbidity was 34%. Hemorrhage (11.2%) was the most frequent complication. The rest of the complications were infection (10.4%), neurologic (5.4%), gastrointestinal (4.5%), pulmonary (3.6%), cardiovascular (2.7%), nerve lesions (2.7%), lymphocele (0.9%) and urinary fistula (0.9%). The post-TX mortality was 6.5% (7/118), although it was significantly lower in the patients immunosuppressed with CSA-PRED (1.6%) than in those treated with AZA-PRED (10.3%).
Universidad de Alcalá de Henares, Madrid, España.
F J
FJ
Burgos Revilla
L
L
Orofino Azcue
J
J
del Hoyo Campos
R
R
Rodríguez Rodríguez
R
R
Marcen Letosa
V
V
Gómez Dosantos
A
A
Escudero Barrilero
J
J
Ortuño Mirete
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012086:Reoperation / Q000379:methods; D017211:Treatment Failure
Trasplantectomía del injerto renal.