[Systematic extracapsular transplantectomy of non-functioning renal graft]

Area of Science:

• Nephrology
• Transplant Surgery

Context:

• Renal transplantation is a life-saving procedure for end-stage renal disease.
• Transplantectomy, the removal of a kidney allograft, is a significant complication.
• Extracapsular transplantectomy is a specific surgical technique.

Purpose:

• To analyze the experience and outcomes of extracapsular transplantectomy at a single Renal Transplantation Unit.
• To identify the primary causes of secondary renal failure necessitating transplantectomy.
• To compare the outcomes of orthotopic versus iliac fossa graft transplantectomies.

Summary:

• This study details 85 transplantectomies out of 317 renal transplants (26.85%).
• Immunological causes accounted for 80% of secondary renal failure leading to transplantectomy.
• Orthotopic graft transplantectomy presented surgical simplicity compared to iliac fossa placements.
• Multi-center data from 18 Spanish centers (7,226 transplants, 1,112 transplantectomies) are included.
• The series reported a 4.7% mortality rate, 10.5% morbidity, and minimal intra-operative failures.

Impact:

• Provides critical insights into the indications and outcomes of transplantectomy.
• Highlights the predominant role of immunological factors in graft loss requiring removal.
• Offers valuable data for surgical planning and patient management in renal transplantation.
• Contributes to the broader understanding of transplantectomy outcomes across multiple centers.