Video-assisted thoracoscopic surgery after renal transplantation: A single-institution experience.
BACKGROUND
The number of renal transplantations performed for patients with chronic kidney disease has increased in Japan, but little is known about the outcomes in those who subsequently undergo video-assisted thoracoscopic surgery (VATS). We therefore investigated the outcomes of consecutive patients requiring VATS after renal transplantation at our institute.


METHODS
We retrospectively collected the clinical data for patients undergoing VATS after renal transplantation between January 2003 and September 2014. Specifically, we compared the serum creatinine level and estimated glomerular filtration rate preoperatively and postoperatively, and investigated the postoperative complications.


RESULTS
In total, 12 patients underwent VATS after renal transplantation during the study period. All patients received two or three immunosuppressive agents. Operative methods used included VATS wedge resection (n = 4), segmentectomy (n = 4), lobectomy (n = 2), mediastinal tumor resection (n = 1), and chest wall tumor resection (n = 1). No patients required perioperative hemodialysis. There were no intraoperative complications, but one patient developed postoperative hemorrhagic cystitis and another developed pneumonia. One patient developed pneumocystis pneumonia 2 months after left lower lobectomy and required hemodialysis. No further hemodialysis was required by any patient. Of note, no statistically significant differences were observed between the preoperative and postoperative serum creatinine level (P = 0.666) and estimated glomerular filtration rate (P = 0.388). There were no in-hospital deaths. Univariate analysis revealed no significant risk factors for postoperative complications.


CONCLUSIONS
This report showed favorable results for VATS after renal transplantation. However, clinicians must remain vigilant for complications because transplant recipients remain permanently immunocompromised.
Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan.
Hideyuki
H
Maeda
Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan.
Masato
M
Kanzaki
Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan.
Kei
K
Sakamoto
Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan.
Takuma
T
Kikkawa
Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan.
Tamami
T
Isaka
Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan.
Kunihiro
K
Oyama
Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan.
Masahide
M
Murasugi
Department of Surgery III, Tokyo Women's Medical University, Tokyo, Japan.
Shohei
S
Fuchinoue
Department of Urology, Tokyo Women's Medical University, Tokyo, Japan.
Kazunari
K
Tanabe
Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan.
Takamasa
T
Onuki
D000368:Aged; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D005919:Glomerular Filtration Rate; D006801:Humans; D007564:Japan; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome
D015415:Biomarkers; D003404:Creatinine
Renal transplantation; thoracic surgery; video-assisted thoracoscopic surgery