title: Renal transplant in patients with polycystic disease: the Italian experience.
abstract: We analyzed the results of kidney transplantation in autosomal dominent polycystic kidney disease (ADPKD) patients in Italy, including 14,305 transplantations performed from January 2002 to December 2010, including: 12,859 first single or double kidneys from cadaveric donors (13% polycystic), 172 combined liver-kidney cases (22% polycystic), and 1,303 living-donor organs (7% polycystic). Among the first transplantations (12,008 single, 851 double), with follow-ups ranging from 16 to 120 months, polycystic patients demonstrated better graft survival compared with other kidney diseases (86% vs 82% at 5 years; P < .01); mortality was not different (92% vs 79% at 1 year). A better trend was obtained also among combined liver-kidney transplantations in ADPKD. Regarding pretransplantation management of polycystic patients, we noticed a conservative attitude in 32/35 transplant centers. The main indication for nephrectomy was for the lack of abdominal space. Regarding instrumental studies, 86% of centers asked for second-level investigations computerized tomography for kidney dimensions. Radiologic investigations for vasculocerebral malformations were required in 97% of the centers: 74% as a routine and 23% in the presence of familial history of cerebral hemorrhage. Polycystic patients are good candidates for kidney transplantation with correct management before transplantation.
authors.affiliation: Nephrology and Dialysis Unit, Department of Specialist Medicine, Morgagni Hospital, Forlì, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mosconi
authors.forename: E
authors.initials: E
authors.lastname: Persici
authors.forename: V
authors.initials: V
authors.lastname: Cuna
authors.forename: M
authors.initials: M
authors.lastname: Pedone
authors.forename: M
authors.initials: M
authors.lastname: Tonioli
authors.forename: D
authors.initials: D
authors.lastname: Conte
authors.forename: A
authors.initials: A
authors.lastname: Ricci
authors.forename: G
authors.initials: G
authors.lastname: Feliciangeli
authors.forename: G
authors.initials: G
authors.lastname: La Manna
authors.forename: A
authors.initials: A
authors.lastname: Nanni Costa
authors.forename: S
authors.initials: S
authors.lastname: Stefoni
mesh_terms: D006801:Humans; D007558:Italy; D016030:Kidney Transplantation; D007690:Polycystic Kidney Diseases / Q000601:surgery*; D014019:Tissue Donors