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Updated: May 24, 2026
07:30
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Allograft nephrectomy: Surgical aspects and alternatives.
Anna Goujon1, Thomas Prudhomme2, Diana Kassab3
1Department of Urology, Rennes University Hospital, Rennes, France.
Transplantation Reviews (Orlando, Fla.)
|May 22, 2026
Summary
Allograft nephrectomy (AN) involves removing a failed kidney transplant. The extraperitoneal subcapsular approach is safest, while arterial embolization offers a less invasive alternative or adjunct for managing graft intolerance.
Area of Science:
- Nephrology
- Urology
- Transplant Surgery
Background:
- Allograft nephrectomy (AN) is a rare but serious procedure after kidney transplant failure or neoplasia.
- Systematic review of current knowledge on AN surgical techniques, complications, and alternatives.
Purpose of the Study:
- To inform French Association of Urology guidelines on allograft nephrectomy.
- To review surgical techniques, complications, and alternatives for AN.
Main Methods:
- Systematic review following PRISMA guidelines.
- PubMed/MEDLINE search (January 2000-March 2024) for non-functional kidney transplants requiring AN or alternatives.
- Exclusion of case reports, editorials, and non-systematic reviews.
Main Results:
- Open extraperitoneal approach is predominant for AN.
- Subcapsular AN approach may reduce operative time, bleeding, and complications, though morbidity data are conflicting.
- Arterial embolization achieves >80% success with lower mortality/morbidity than AN, but can lead to secondary AN; pre-AN embolization reduces bleeding and operative time.
Conclusions:
- The extraperitoneal subcapsular approach is the safest surgical option for AN.
- Arterial embolization is a viable alternative or adjuvant for graft intolerance syndrome post-transplant failure.
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