Parmentier-de León C, Cruz-Martínez R, Quintero-Quintero M, Ixcayau-Hernández J, Cano-González H, Contreras-Saldívar A, Alberú-Gómez J, Vilatobá-Chapa M

Language: Spanish
References: 9
Page: 37-40
PDF size: 269.29 Kb.

ABSTRACT

Introduction: Autosomal dominant polycystic kidney disease (ADPKD), is the most common hereditary cause of kidney disease with an estimated of 12.5 million cases worldwide, it occurs in one in every 500 to 1000 livebirths.Indications for nephrectomy of the native kidneys are recurrent infections, hematuria, abdominal or flank pain, early satiety, loss of domain and suspicion of malignancy. Only 20% of patients with ADPKD will need a nephrectomy. Although indications for nephrectomy are well established, the timing for the procedure is still a matter of great controversy. Case report: We present the case of a 48-year-old male with end stage chronic kidney disease, secondary to ADPKD. He was sent Instituto Nacional de Ciencias Médicas y Nutrición to initiate protocol to enter the waiting list for deceased kidney donation. We received an offer for a kidney allograft from 56-year-old, male, brain death donor (DBD), with a KDRI of 1.11 and KDPI of 61%. A bilateral nephrectomy with simultaneous kidney transplantation was performed without any complications, with a cold ischemia of 25 hours and 35 minutes and a warm ischemia of 49 minutes. He was sent home on postoperative day 10, without any complications and follow-up at the external consultation. Discussion: The majority of the studies that refer to simultaneous nephrectomy and renal transplantation were done in living donor kidney transplantation, with good results in both patient, graft survival and quality of life of the recipients. Conclusions: Even if surgical time and hospitalization days were longer, we believe that it is possible to do this kind of procedures in patients that are listed for deceased kidney allografts with excellent results.

REFERENCES

1. Ahmad SB, Inouye B, Phelan MS, Kramer AC, Sulek J, Weir MR et al. Live donor renal transplant with simultaneous bilateral nephrectomy for autosomal dominant polycystic kidney disease is feasible and satisfactory at long-term follow-up. Transplantation. 2016; 100 (2): 407-415.

2. Dengu F, Azhar B, Patel S, Hakim N. Bilateral nephrectomy for autosomal dominant polycystic kidney disease and timing of kidney transplant: a review of the technical advances in surgical management of autosomal dominant polycystic disease. Exp Clin Transplant [Internet]. 2015 Jun [Cited 2019 Dec 3]; 13 (3): 209-213. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26086830.

3. Patel P, Horsfield C, Compton F, Taylor J, Koffman G, Olsburgh J. Native nephrectomy in transplant patients with autosomal dominant polycystic kidney disease. Ann R Coll Surg Engl [Internet]. 2011 Jul [Cited 2019 Dec 5]; 93 (5): 391-395. Available from: http://publishing.rcseng.ac.uk/doi/10.1308/003588411X582690.

4. Wu G, Somlo S. Molecular genetics and mechanism of autosomal dominant polycystic kidney disease. Mol Genet Metab. 2000; 69 (1): 1-15.

5. Rodríguez-Faba O, Breda A, Villavicencio H. Renal transplantation and polycystic: surgical considerations. Actas Urológicas Españolas. 2014; 38 (1): 28-33.

6. Hateboer N, Dijk MAV, Bogdanova N, Coto E, Saggar-Malik AK, San Millan JL et al. Comparison of phenotypes of polycystic kidney disease types 1 and 2. Lancet. 1999; 353 (9147): 103-107.

7. Kramer A, Sausville J, Haririan A, Bartlett S, Cooper M, Phelan M. Simultaneous bilateral native nephrectomy and living donor renal transplantation are successful for polycystic kidney disease: the university of Maryland experience. J Urol. 2009; 181 (2): 724-728.

8. Argyrou C, Moris D, Vernadakis S. Tailoring the “Perfect Fit” for renal transplant recipients with end-stage polycystic kidney disease: indications and timing of native nephrectomy. In vivo [Internet]. 2019 [Cited Dec 3]; 31 (3): 307-312. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28438856.

9. Kim JH, Chae SY, Bae HJ, Kim JI, Moon IS, Choi BS et al. Clinical outcome of simultaneous native nephrectomy and kidney transplantation in patients with autosomal dominant polycystic kidney disease. Transplant Proc. 2016; 48 (3): 840-843.