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International Urology and Nephrology

, Volume 50, Issue 10, pp 1787–1793 | Cite as

Transplant nephrectomy after graft failure: is it so risky? Impact on morbidity, mortality and alloimmunization

  • Y. Chowaniec
  • F. Luyckx
  • G. Karam
  • P. Glemain
  • J. Dantal
  • J. Rigaud
  • J. BranchereauEmail author
Urology - Original Paper

Abstract

Purpose

To determine the impact of transplant nephrectomy on morbidity and mortality and HLA immunization.

Methods

All patients who underwent transplant nephrectomy in our centre between 2000 and 2016 were included in this study. A total of 2822 renal transplantations and 180 transplant nephrectomies were performed during this period.

Results

The indications for transplant nephrectomy were graft intolerance syndrome: 47.2%, sepsis: 22.2%, vascular thrombosis: 15.5%, tumour: 8.3% and other 6.8%. Transplant nephrectomies were performed via an intracapsular approach in 61.7% of cases. The blood transfusion rate was 50%, the morbidity rate was 38% and the mortality rate was 3%. Transplant nephrectomies more than 12 months after renal transplant failure were associated with more complications (p = 0.006). Transfusions in the context of transplant nephrectomy had no significant impact on alloimmunization.

Conclusion

The risk of bleeding, and therefore of transfusion, constitutes the major challenge of this surgery in patients eligible for retransplantation. Even if transfusions in this context of transplant nephrectomy had no significant impact on alloimmunization, this high-risk surgery, whenever possible, must be performed electively in a well-prepared patient.

Keywords

Kidney transplant Nephrectomy 

Notes

Author contributions

YC: Data Collection and Manuscript writing; FL: Statistical analysis; GK, PG, JD, JR: Project development; and JB: Project development and Manuscript writing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.Centre de Recherche en Transplantation et Immunologie UMR 1064INSERM, Université de NantesNantesFrance
  2. 2.Institut of Transplantation, Urology and Nephrology (ITUN)CHU NantesNantesFrance
  3. 3.Service d’UrologieHôpital de la Roche sur YonLa Roche sur YonFrance

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