Department of Urology, University of Michigan Health System, 1500 East Medical Center Drive, TC 3875, Ann Arbor, MI, 48109.

We hypothesized that patients undergoing bilateral native nephrectomy have a better perioperative course and earlier recovery when renal transplantation is performed before nephrectomy rather than afterwards, since the anuric state is avoided.

Of 9 patients undergoing bilateral nephrectomy between November 2000 and December 2005, 5 had nephrectomy before renal transplant and 4 had nephrectomy after transplant. Hospital course and complications within 3 months of each operation were compared.

Patients who underwent bilateral nephrectomy prior to transplantation spent more days in the hospital overall (mean = 25 days) than did patients who received their transplant before nephrectomy (mean = 14 days). Serum creatinine levels over the course of both operations were greater for the group maintained on dialysis, but both groups had similar values at the time of discharge from the second procedure and at 1-year follow-up. Major and minor complications were more frequent in those who underwent nephrectomy before transplant.

The order of operations for patients undergoing both bilateral nephrectomy and renal transplantation impacts perioperative course, especially in the first 3 months after the operations are completed. Bilateral native nephrectomy before renal transplantation is associated with a greater risk of complications and longer overall duration of hospitalization.

Written by:
Kaplan JR, Sung RS, Wolf JS.   Are you the author?

Reference:
UIJ. 2008 Dec;1(5).
doi:10.3834/uij.1939-4810.2008.12.04

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