Simultaneous transabdominal bilateral nephrectomy in potential kidney transplant recipients

Area of Science:

• Nephrology
• Transplant Surgery
• Surgical Complications

Background:

• Bilateral nephrectomy is indicated for kidney transplant recipients with recurrent infections in polycystic kidneys or chronic pyelonephritis.
• Indications include recurrent infections, chronic pyelonephritis, and significantly enlarged kidneys.

Purpose of the Study:

• To analyze the frequency and types of complications following simultaneous bilateral transperitoneal nephrectomy.
• Evaluate the outcomes of this surgical approach in potential kidney graft recipients.

Main Methods:

• Twenty hemodialysis patients underwent simultaneous bilateral transperitoneal nephrectomy between 1996 and 2004.
• Procedures were performed via transverse or midline incisions.
• Patient cohort included those with autosomal-dominant polycystic kidney disease and reflux-induced chronic pyelonephritis.

Main Results:

• No fatal outcomes occurred, but three patients required intensive care unit (ICU) admission.
• Intraoperative spleen injury occurred in five patients.
• Postoperative complications affected 45% of patients, including delayed wound healing, hernias, abdominal pain, hematomas, duodenal ulcers, and subileus. Thrombosis of dialysis access was noted in five patients.

Conclusions:

• Simultaneous transabdominal bilateral nephrectomy is associated with a significant risk of postoperative complications.
• Despite the risks, this procedure may be beneficial by avoiding repeated surgeries for eligible kidney graft recipients.