Kidney transplantation with concomitant unilateral nephrectomy: a matched-pair analysis on complications and outcome.
BACKGROUND
We sought to determine the impact of kidney transplantation with simultaneous unilateral nephrectomy on perioperative morbidity and patient and graft survival.


METHODS
From January 1990 to May 2004, 75 kidney transplantations with simultaneous unilateral nephrectomy (group NE+) were performed at the University of Freiburg. Of these, 49 had polycystic kidney disease. Patients of group NE+ were matched with 75 kidney transplants without nephrectomy (group NE-). Immunosuppressive maintenance therapy in both groups was based on cyclosporine A, mycophenolate mofetil or azathioprine, and prednisone. Mean follow up was 4.1 yrs (range 0.3-11.7 yrs).


RESULTS
Patient survival rate at 1 and 5 yrs was 95% and 84% versus 95% and 93% in group NE+ and NE-, resp. (P=0.56). Accordingly, kidney function rate was 85% and 74% in group NE+ versus 89% and 79% in group NE- (P=0.89). Perioperative (90 days) mortality rate in group NE+ was 1.3% and 2.7% in group NE- (P=0.56). Perioperative surgical complications were similar in both groups.


CONCLUSIONS
Kidney transplantation with concomitant unilateral nephrectomy has no negative impact on patient or graft survival and is associated with a reasonable morbidity rate.
Department of General and Digestive Surgery, University of Freiburg, Hugstetter Strasse 55, D-79106 Freiburg i. Brsg., Germany. oliverdrognitz@web.de
Oliver
O
Drognitz
Günter
G
Kirste
Inga
I
Schramm
Angelika
A
Assmann
Martin
M
Pohl
Heike
H
Gobel
Oliver
O
Thomusch
Ulrich Theodor
UT
Hopt
Przemyslaw
P
Pisarski
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009017:Morbidity; D009392:Nephrectomy; D007690:Polycystic Kidney Diseases / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology