title: Transplant nephrectomy: what are the surgical risks?
abstract: BACKGROUND
  Whether or not to remove a failed renal graft has been the subject of much debate. One reason for a cautious approach to graft removal is its high morbidity and mortality rates. We analyzed the morbidity, mortality, and risk factors of transplant nephrectomy at our center.
  
  
  METHODS
  We included 157 cases of transplant nephrectomy in 143 patients, performed between January 2000 and May 2012 at the Academic Medical Center, Amsterdam. Patient data were collected retrospectively.
  
  
  RESULTS
  A total of 32 surgical complications occurred after transplant nephrectomy (20%) and 16 patients needed surgical re-intervention (10%). Hemorrhage and infection are the most frequent causes of surgical complications (14%). The mortality rate was 3.2%. There were no significant differences in characteristics and timing of transplant nephrectomy between the group with surgical complications and the group without. A total of 59 re-transplantations were performed in 57 patients (38%).
  
  
  CONCLUSIONS
  Transplant nephrectomy is associated with high morbidity and mortality rates. We found no significant risk factors for surgical complications following transplant nephrectomy and no significant association between timing of transplant nephrectomy and surgical complications. Steps to reduce these complications need further investigation.
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Victor P
authors.initials: VP
authors.lastname: Alberts
authors.forename: Robert C
authors.initials: RC
authors.lastname: Minnee
authors.forename: Frederike J
authors.initials: FJ
authors.lastname: Bemelman
authors.forename: Karlijn A M I
authors.initials: KA
authors.lastname: van Donselaar-van der Pant
authors.forename: Mirza M
authors.initials: MM
authors.lastname: Idu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009392:Nephrectomy / Q000009:adverse effects* / Q000401:mortality; D009426:Netherlands / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D012086:Reoperation / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult