Allograft nephrectomy: a single-institution, 10-year experience.

Area of Science:

• Nephrology
• Transplant Surgery
• Immunology

Background:

• Allograft nephrectomy (AN) is frequently complicated.
• Early AN (<1 year) is theorized to have fewer complications than late AN.
• Intracapsular (ICAN) and extracapsular (ECAN) AN may differ in allosensitization and surgical outcomes.

Purpose of the Study:

• Compare surgical outcomes of early versus late AN.
• Evaluate ICAN versus ECAN regarding surgical outcomes and panel reactive antibodies (PRA) variation.

Main Methods:

• Retrospective analysis of 104 AN cases (January 2000 - October 2012).
• Comparison of early (<1 year) versus late (≥1 year) AN.
• Comparison of ICAN versus ECAN techniques within the late AN group.
• Statistical analysis of surgical outcomes and %PRA variation.

Main Results:

• Late AN (n=72) showed significantly less blood loss, shorter hospital stay, and fewer complications than early AN (n=32).
• No significant difference in surgical outcomes or %PRA variation between ICAN and ECAN.
• Re-listing rates for transplantation were similar for early vs. late AN and ICAN vs. ECAN.

Conclusions:

• Early AN is associated with higher surgical complication rates.
• ICAN and ECAN demonstrate comparable surgical and postoperative outcomes.
• Allosensitization and re-transplantation chances are not negatively impacted by ICAN compared to ECAN.