MP52-20 KIDNEY ALLOGRAFT NEPHRECTOMY – A RETROSPECTIVE REVIEW OF INDICATIONS AND SURGICAL OUTCOMES: SINGLE INSTITUTION, 18 YEARS OF EXPERIENCES

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery II (MP52)1 Apr 2020MP52-20 KIDNEY ALLOGRAFT NEPHRECTOMY – A RETROSPECTIVE REVIEW OF INDICATIONS AND SURGICAL OUTCOMES: SINGLE INSTITUTION, 18 YEARS OF EXPERIENCES Vincent Khor*, Edwin Jonathan Aslim, Jin Yong, Kenneth Chen, and Valerie Huei Li Gan Vincent Khor*Vincent Khor* More articles by this author , Edwin Jonathan AslimEdwin Jonathan Aslim More articles by this author , Jin YongJin Yong More articles by this author , Kenneth ChenKenneth Chen More articles by this author , and Valerie Huei Li GanValerie Huei Li Gan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000914.020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Allograft nephrectomy (AN) is associated with significant morbidity and mortality. Its incidence and practice vary across different institutions. Although some authors claim that allograft nephrectomy improves patient survival and affects the outcomes of subsequent renal transplantation, routine removal of a failed graft is not currently practised. We conducted this study to review the indications and outcomes of allograft nephrectomies performed at our institution over the past 18 years. METHODS: We identified patients who underwent allograft nephrectomy at our institution, between January 2000 and December 2018, regardless of the institution where the initial transplantations were performed. Medical records were reviewed retrospectively. Patients were classified into 3 groups according to the timing of allograft nephrectomy from their transplant: very early (within 30 days), early (within 1 to 12 months) and late (after 12 months). Demographic data, indications, perioperative data including operative time, surgical technique, approach, perioperative blood transfusion, surgical outcome and post-operative complication were analysed. Descriptive statistics was used for this study. Statistical analysis was performed using the Fisher's exact test and ANOVA test for categorical and continuous variables respectively, with Stata SE version 12.1. Statistical significance was given if p < 0.05. RESULTS: 92 graft nephrectomies were performed within the study period. 2 cases were excluded due to incomplete data. The incidence of graft nephrectomy at our institution was 9.3%. Overall, the common indications for allograft nephrectomy at our institution were graft infections (33%), persistent gross haematuria (24%) and renal infarcts (15%). When compared among the groups, renal infarct was the most common indication for the very early AN group while graft infection was most common for both early AN and late AN groups. Post-operative mortality rate was 4.4% (4/90) and major morbidity rate was 22.2% (20/90). The most common minor and major complications were blood transfusion and surgical site infection respectively. There was significantly higher rate of perioperative blood transfusion in the late AN group (p = 0.025) and in patients who had subcapsular nephrectomy (as compared to extracapsular). Our data also showed that patients who underwent late graft nephrectomy had shorter survival after surgery as compared to the other two groups (p < 0.001). CONCLUSIONS: Majority of graft nephrectomies were performed late (more than 1 year after transplantation) at our institution. Overall, the most common indication for this procedure was graft infection, followed by persistent gross haematuria and renal infarcts. Patients who underwent late graft nephrectomy had higher risk of complications and shorter survival after surgery. Source of Funding: No funding was received for this study. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e780-e780 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vincent Khor* More articles by this author Edwin Jonathan Aslim More articles by this author Jin Yong More articles by this author Kenneth Chen More articles by this author Valerie Huei Li Gan More articles by this author Expand All Advertisement PDF downloadLoading ...