pISSN 3022-6783
eISSN 3022-7712

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J Korean Soc Transplant 2016; 30(1): 24-30

Published online March 31, 2016

https://doi.org/10.4285/jkstn.2016.30.1.24

© The Korean Society for Transplantation

Effect of Simultaneous Nephrectomy on Perioperative Blood Pressure and Graft Outcome in Renal Transplant Recipients with Autosomal Dominant Polycystic Kidney Disease

Hyung Ah Jo, M.D.1, Hayne Cho Park, M.D.2, Hyunsuk Kim, M.D.1, Miyeun Han, M.D.1, Jong Cheol Jeong, M.D.3, Kook-Hwan Oh, M.D.1, Jaeseok Yang, M.D.4, Hee Jung Jeon, M.D.5, Tai Yeon Koo, M.D.4, Jongwon Ha, M.D.6, Cheol Kwak, M.D.7, Young-Hwan Hwang, M.D.8 and Curie Ahn, M.D.1,4

Department of Internal Medicine, Seoul National University College of Medicine1, Seoul, Department of Internal Medicine, The Armed Forces Capital Hospital2, Seongnam, Department of Nephrology, Ajou University School of Medicine3, Suwon, Transplantation Center, Seoul National University Hospital, Seoul National University College of Medicine4, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital5, Departments of Surgery6 and Urology7, Seoul National University College of Medicine, Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine8, Seoul, Korea

Correspondence to: Young-Hwan Hwang
Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, 68 Hangeulbiseong-ro, Nowon-gu, Seoul 01830, Korea
Tel: 82-2-970-8205, Fax: 82-2-971-8212
E-mail:ondahl@eulji.ac.kr

Received: July 31, 2015; Revised: December 28, 2015; Accepted: December 28, 2015

Abstract

Background: For various reasons, kidney transplant recipients with autosomal dominant polycystic kidney disease (ADPKD) often undergo native nephrectomy in preparation for the transplantation. Simultaneous nephrectomy can result in hypotensive events perioperatively and affect transplant outcome adversely. Our aim was to evaluate the effect of simultaneous native nephrectomy (SNx) on perioperative blood pressure and graft outcome compared to non-nephrectomy (NNx) in renal transplant recipients with ADPKD.

Methods: Data regarding renal function and blood pressure were collected from 42 renal transplant recipients with ADPKD. The primary outcome was graft function over 1 year post-transplant. The secondary outcomes were patient and graft survival, postoperative hypotensive events, and blood pressure control. We compared units of anti-hypertensive medication used by transplanted ADPKD patients in the SNx and NNx groups.

Results: Patients with SNx during kidney transplantation showed similar rates of patient and graft survival and renal function. Although they had significantly more hypotensive events during the perioperative period (69.2% vs. 37.5% in NNx, P=0.045), no harmful influence on renal function was observed. No difference in mean blood pressure during the 1-year post-transplant period was observed between the two groups; however, the SNx group required fewer units of anti-hypertensive medication.

Conclusions: SNx is a relatively safe procedure. Graft outcome in the SNx group was not inferior to that of the NNx group, and patients with SNx can have well-controlled blood pressure.

Keywords: Autosomal dominant polycystic kidney, Nephrectomy, Kidney transplantation