title: One hundred consecutive kidney transplantations with simultaneous ipsilateral nephrectomy in patients with autosomal dominant polycystic kidney disease.
abstract: OBJECTIVE
  Surgical management of autosomal dominant polycystic kidney disease (ADPKD) in patients awaiting renal transplantation is a challenging task.
  
  
  METHODS
  From 1998 to 2009, a total of 100 consecutive renal transplantations with simultaneous unilateral nephrectomy were performed in 59 men and 41 women with ADPKD and end-stage renal failure. About 38% received kidney allografts from living donors. The ipsilateral polycystic kidney was removed at the time of renal transplantation. Immunosuppressive therapy was not modified. Cold ischaemia time was 155 (38-204 min) versus 910 min (95-2760 min) for living versus deceased donor transplantation. Mean weight of removed kidneys was 2002 g (414-8850 g). Mean follow-up was 3.0 years (0.8-10.0 years).
  
  
  RESULTS
  Overall patient and graft survival were 97 and 96% at 1 year and 93 and 80% at 5 years, respectively. Serum creatinine at current follow-up was 1.49 (0.8-2.8) mg/dL. Surgical complications, which might be associated with simultaneous nephrectomy requiring re-operation, occurred in 12% (lymphocele 4%, hernia 4%, post-operative haematoma or bleeding 4%). None of the patients died peri-operatively.
  
  
  CONCLUSIONS
  Renal transplantation with simultaneous unilateral nephrectomy in ADPKD is a reasonable procedure for patients suffering from massively enlarged native kidneys.
authors.affiliation: Department of General and Digestive Surgery, University of Freiburg, Freiburg i. Brsg., Germany. hannes.neeff@uniklinik-freiburg.de
authors.forename: Hannes Philipp
authors.initials: HP
authors.lastname: Neeff
authors.forename: Przemyslaw
authors.initials: P
authors.lastname: Pisarski
authors.forename: Dietlind
authors.initials: D
authors.lastname: Tittelbach-Helmrich
authors.forename: Konstantin
authors.initials: K
authors.lastname: Karajanev
authors.forename: Hartmut P H
authors.initials: HP
authors.lastname: Neumann
authors.forename: Ulrich Theodor
authors.initials: UT
authors.lastname: Hopt
authors.forename: Oliver
authors.initials: O
authors.lastname: Drognitz
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007668:Kidney / Q000502:physiology; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D016891:Polycystic Kidney, Autosomal Dominant / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome