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[Non-functioning renal graft: indications for transplant excision].

M Mora Durbán, P Cárcamo Valor, J Navarro Sebastían

    Archivos Espanoles De Urologia
    |November 1, 1989
    PubMed
    Summary

    Renal transplant nephrectomy is often performed within one year post-transplant due to graft failure from rejection or thrombosis. While complications are infrequent, transplant nephrectomy outcomes are crucial for long-term patient and graft survival.

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    Area of Science:

    • Nephrology
    • Transplant Surgery
    • Pathology

    Context:

    • Study of 107 renal transplants, focusing on 25 patients with graft failure requiring dialysis.
    • 20 patients underwent renal transplant nephrectomy due to graft failure (progressive loss or initial non-function).
    • 3 viable grafts were removed due to urologic complications or hemorrhage post-biopsy.

    Purpose:

    • To analyze indications, timing, surgical techniques, complications, and outcomes of renal transplant nephrectomy.
    • To correlate clinical and histological findings in removed grafts.
    • To assess long-term patient and graft survival rates post-transplant nephrectomy.

    Summary:

    • Rejection (45%) and arterial thrombosis (25%) were primary indications for nephrectomy, typically within one year post-transplant.

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  • Subcapsular technique used in 60% of nephrectomies; classical in others, including emergency cases.
  • Low complication rate (10%) and one surgery-related death; clinical and histological diagnoses correlated well for acute rejection and vascular thrombosis.

    • Impact:

    • Highlights the importance of timely graft nephrectomy for managing complications and improving patient outcomes.
    • Provides insights into the correlation between clinical presentation and histological findings in failed renal transplants.
    • Contributes to understanding long-term survival rates (10-year patient survival 87.4%, graft survival 62.9%) after renal transplant nephrectomy.