title: Review of a transplantectomy series.
abstract: BACKGROUND
  Renal transplant nephrectomy is a complex process carried out in various situations of renal graft failure. The objective of the study was to describe the experience in our center and to evaluate the safety and efficacy in performing transplantectomies.
  
  
  METHODS
  This is a retrospective study of 70 transplantectomies performed at our center from 1995 to 2013. Multiple variables related to complications (according to Clavien classification) and mortality as the cause of nephrectomy, surgical technique, or urgent or elective surgery were analyzed.
  
  
  RESULTS
  Seventy transplantectomies from a total of 996 transplantations were performed at our center. The mean age was 46.2 years, with 47 men. The most frequent cause of nephrectomy was chronic rejection graft intolerance of 58.5%; 75.7% of the surgical technique was subcapsular. The indication was scheduled at 78.57% (n = 55). Serious complications, defined as Clavien >III (excluded deaths, Clavien V), occurred in 21.43% (n = 15). There were 8 deaths, 6 of which were associated with the clinical severity of patients with urgent indication. The analysis unvariate transplantectomies scheduled group revealed no factor associated with increased morbidity and mortality.
  
  
  CONCLUSIONS
  In referral centers, nephrectomy is safe and effective in the treatment of complications of renal graft surgical technique. The increased morbidity and mortality of the procedure depends mainly on the indication and clinical condition of the patient, severity increasing in situations where urgent nephrectomy is performed.
authors: Urology Service, Reina Sofia University Hospital, Córdoba, Spain. Electronic address: areber87@hotmail.com.
authors: A J A
authors: AJ
authors: Bonilla
authors: Urology Service, Reina Sofia University Hospital, Córdoba, Spain.
authors: A G
authors: AG
authors: Alfaro
authors: Urology Service, Reina Sofia University Hospital, Córdoba, Spain.
authors: J P C
authors: JP
authors: Henández
authors: Urology Service, Reina Sofia University Hospital, Córdoba, Spain.
authors: J H G
authors: JH
authors: Rubio
authors: Urology Service, Reina Sofia University Hospital, Córdoba, Spain.
authors: E G
authors: EG
authors: Gómez
authors: Urology Service, Reina Sofia University Hospital, Córdoba, Spain.
authors: J C
authors: JC
authors: Valiente
authors: Urology Service, Reina Sofia University Hospital, Córdoba, Spain.
authors: J M R
authors: JM
authors: García
authors: Urology Service, Reina Sofia University Hospital, Córdoba, Spain.
authors: J M
authors: JM
authors: López
authors: Urology Service, Reina Sofia University Hospital, Córdoba, Spain.
authors: M J R
authors: MJ
authors: Tapia
mesh_terms: D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000401:mortality / Q000601:surgery*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation / Q000401:mortality; D012189:Retrospective Studies; D016896:Treatment Outcome