Top

Published in:

Open Access 01-06-2018 | Educational Review

Graft nephrectomy in children

Authors: Benedict L. Phillips, Chris J. Callaghan

Published in: Pediatric Nephrology | Issue 6/2018

Abstract

Kidney transplantation is recognised as the gold standard treatment of end-stage renal disease in most children, with excellent graft survival rates. When graft failure occurs, renal transplant recipients (RTRs) have the option of removal of the transplant (graft nephrectomy [GN]), or leaving the failed transplant in situ. The aims of this review are to discuss the indications for GN, surgical techniques, outcomes after GN (including risks of allosensitisation and the impact on subsequent transplants), and the possible role of routine GN in the asymptomatic RTR with a failed renal allograft. Literature in both the pediatric and adult renal transplant fields is reviewed. We also discuss how future research in this area could advance our knowledge of which patients to select for GN, and the most appropriate surgical approach.

North American Pediatric Renal Trials and Collaborative Studies. Annual transplant report 2014. Available from https://web.emmes.com/study/ped/annlrept/annualrept2014.pdf. Accessed on 27 March 2017

Minson S, Munoz M, Vergara I, Mraz M, Vaughan R, Rees L, Olsburgh J, Calder F, Shroff R (2013) Nephrectomy for the failed renal allograft in children: predictors and outcomes. Pediatr Nephrol 28:1299–1305CrossRefPubMed

Zerouali F, Levtchenko EN, Feitz WF, Cornelissen EA, Monnens LA (2004) Renal transplant nephrectomy in children: can an aggressive approach be recommended? Pediatr Transplant 8:561–564CrossRefPubMed

Andrews PA, Standards Committee of the British Transplantation Society (2014) Summary of the British Transplantation Society guidelines for management of the failing kidney transplant. Transplantation 98:1130–1133CrossRefPubMed

Rees L, Kim JJ (2015) HLA sensitisation: can it be prevented? Pediatr Nephrol 30:577–587CrossRefPubMed

Olsburgh J, Zakri RH, Horsfield C, Collins R, Fairweather J, O’Donnell P, Koffman G (2016) TCC in transplant ureter—when and when not to preserve the transplant kidney. Am J Transplant 16:704–711CrossRefPubMed

Tillou X, Doerfler A, Collon S, Kleinclauss F, Patard JJ, Badet L, Barrou B, Audet M, Bensadoun H, Berthoux E, Bigot P, Boutin JM, Bouzguenda Y, Chambade D, Codas R, Dantal J, Deturmeny J, Devonec M, Dugardin F, Ferriere JM, Erauso A, Feuillu B, Gigante M, Guy L, Karam G, Lebret T, Neuzillet Y, Legendre C, Perez T, Rerolle JP, Salomon L, Sallusto F, Senechal C, Terrier N, Thuret R, Verhoest G, Petit J, Comité de Transplantation de l’Association Française d’Urologie (CTAFU) (2012) De novo kidney graft tumors: results from a multicentric retrospective national study. Am J Transplant 12:3308–3315CrossRefPubMed

Tillou X, Guleryuz K, Collon S, Doerfler A (2016) Renal cell carcinoma in functional renal graft: toward ablative treatments. Transplant Rev (Orlando) 30:20–26CrossRef

Lopez-Gomez JM, Perez-Flores I, Jofre R, Carretero D, Rodriguez-Benitez P, Villaverde M, Perez-Garcia R, Nassar GM, Niembro E, Ayus JC (2004) Presence of a failed kidney transplant in patients who are on hemodialysis is associated with chronic inflammatory state and erythropoietin resistance. J Am Soc Nephrol 15:2494–2501CrossRefPubMed

10.

Trofe J, Buell JF, Beebe TM, Hanaway MJ, First MR, Alloway RR, Gross TG, Succop P, Woodle ES (2005) Analysis of factors that influence survival with post-transplant lymphoproliferative disorder in renal transplant recipients: the Israel Penn international transplant tumor registry experience. Am J Transplant 5:775–780CrossRefPubMed

11.

Hirsch HH, Randhawa P, AST Infectious Diseases Community of Practice (2013) BK polyomavirus in solid organ transplantation. Am J Transplant 13 [Suppl 4]:179–188CrossRefPubMed

12.

Chandak P, Stojanovic J, Sivaprakasam R, Mamode N, Calder F, Olsburgh J, Drage M, Callaghan C, Taylor J, Koffman G, Taylor J, Marks S, Kessaris N (2015) Is there a difference in patient and graft survival in children weighing <20 kg versus those weighing >20 kg at the time of renal transplantation? [abstract]. Am J Transplant 15 [Suppl 3]:D218

13.

Dharnidharka VR, Fiorina P, Harmon WE (2014) Kidney transplantation in children. N Engl J Med 371:549–558CrossRefPubMed

14.

Sutherland DE, Simmons RL, Howard RJ, Najarian JS (1978) Intracapsular technique of transplant nephrectomy. Surg Gynecol Obstet 146:950–952PubMed

15.

Pagano D, Cintorino D, Li Petri S, di Francesco F, Ricotta C, Argento J, Echeverri GJ, Bertani T, Riva S, Gridelli BG, Spada M (2012) Laparoscopic approach for an intra-abdominal kidney allograft nephrectomy after pediatric transplantation: a case report. Transplant Proc 44:2036–2037CrossRefPubMed

16.

Muller A, Rouviere O (2015) Renal artery embolization—indications, technical approaches and outcomes. Nat Rev Nephrol 11:288–301CrossRefPubMed

17.

Choe J, Shin JH, Yoon HK, Ko GY, Gwon DI, Ko HK, Kim JH, Sung KB (2014) Safety and efficacy of transarterial nephrectomy as an alternative to surgical nephrectomy. Korean J Radiol 15:472–480CrossRefPubMedPubMedCentral

18.

Capozza N, Collura G, Falappa P, Caione P (2007) Renal embolization as an alternative to surgical nephrectomy in children. Transplant Proc 39:1782–1784CrossRefPubMed

19.

Krause I, Cleper R, Belenky A, Atar E, Bar-Nathan N, Davidovits M (2008) Graft intolerance syndrome in children with failed kidney allografts—clinical presentation, treatment options and outcome. Nephrol Dial Transplant 23:4036–4040CrossRefPubMed

20.

Cofan F, Real MI, Vilardell J, Montanya X, Blasco J, Martin P, Oppenheimer F, Gutierrez R, Talbot-Wright R, Alcover J (2002) Percutaneous renal artery embolisation of non-functioning renal allografts with clinical intolerance. Transpl Int 15:149–155CrossRefPubMed

21.

Delgado P, Diaz F, Gonzalez A, Sanchez E, Gutierrez P, Hernandez D, Torres A, Lorenzo V (2005) Intolerance syndrome in failed renal allografts: incidence and efficacy of percutaneous embolization. Am J Kidney Dis 46:339–344CrossRefPubMed

22.

Gonzalez-Satue C, Riera L, Franco E, Escalante E, Dominguez J, Serrallach N (2000) Percutaneous embolization of the failed renal allograft in patients with graft intolerance syndrome. BJU Int 86:610–612CrossRefPubMed

23.

Larini P, Marcato C, Monaco D, Bresciani P, Capocasale E, Mazzoni MP, Dalla Valle R, Busi N (2005) Percutaneous renal artery embolisation of non-functioning allograft. Preliminary experience. Radiol Med 110:501–505PubMed

24.

Neschis DG, Gutta R, Al-Qudah HS, Bartlett ST, Philosophe B, Schweitzer EJ, Flinn WR, Campos L (2007) Intraoperative coil embolization reduces transplant nephrectomy transfusion requirement. Vasc Endovasc Surg 41:335–338CrossRef

25.

Yeast C, Riley JM, Holyoak J, Ross G Jr, Weinstein S, Wakefield M (2016) Use of preoperative embolization prior to transplant nephrectomy. Int Braz J Urol 42:107–112CrossRefPubMedPubMedCentral

26.

Al-Geizawi SM, Singh RP, Zuckerman JM, Requarth JA, Farney AC, Rogers J, Taussig J, Orlando G, Stratta RJ (2015) Role of allograft nephrectomy following kidney graft failure: preliminary experience with pre-operative angiographic kidney embolization. J Nephrol 28:379–385CrossRefPubMed

27.

Jain S, Nyirenda T, Yates J, Munver R (2013) Incidence of renal artery pseudoaneurysm following open and minimally invasive partial nephrectomy: a systematic review and comparative analysis. J Urol 189:1643–1648CrossRefPubMed

28.

Morales A, Gavela E, Kanter J, Beltran S, Sancho A, Escudero V, Crespo J, Pallardo LM (2008) Treatment of renal transplant failure. Transplant Proc 40:2909–2911CrossRefPubMed

29.

Johnston O, Rose C, Landsberg D, Gourlay WA, Gill JS (2007) Nephrectomy after transplant failure: current practice and outcomes. Am J Transplant 7:1961–1967CrossRefPubMed

30.

Secin FP, Rovegno AR, del Rosario BM, Marrugat RE, Davalos Michel M, Fernandez H (2003) Cumulative incidence, indications, morbidity and mortality of transplant nephrectomy and the most appropriate time for graft removal: only nonfunctioning transplants that cause intractable complications should be excised. J Urol 169:1242–1246CrossRefPubMed

31.

O’Sullivan DC, Murphy DM, McLean P, Donovan MG (1994) Transplant nephrectomy over 20 years: factors involved in associated morbidity and mortality. J Urol 151:855–858CrossRefPubMed

32.

Grochowiecki T, Szmidt J, Galazka Z, Nazarewski S, Bojakowska M, Bojakowski K, Swiercz P (2000) Influence of timing of transplant nephrectomy on surgical complications. Transplant Proc 32:1381CrossRefPubMed

33.

Hansen BL, Rohr N, Svendsen V, Birkeland SA (1987) Graft failure and graft nephrectomy without severe complications. Nephrol Dial Transplant 2:189–190PubMed

34.

Vavallo A, Lucarelli G, Bettocchi C, Tedeschi M, Palazzo S, Losappio V, Gesualdo L, Grandaliano G, Selvaggi FP, Battaglia M, Ditonno P (2012) Allograft nephrectomy: what is the best surgical technique? Transplant Proc 44:1922–1925CrossRefPubMed

35.

Freitas R, Malheiro J, Santos C, Costa R, Martins LS, Almeida M, Dias L, Castro-Henriques A, Cabrita A, Silva-Ramos M, Almeida R (2015) Allograft nephrectomy: a single-institution, 10-year experience. Transplant Proc 47:992–995CrossRefPubMed

36.

Mazzucchi E, Nahas WC, Antonopoulos IM, Piovesan AC, Ianhez LE, Arap S (2003) Surgical complications of graft nephrectomy in the modern transplant era. J Urol 170:734–737CrossRefPubMed

37.

Touma NJ, Sener A, Caumartin Y, Warren J, Nguan CY, Luke PP (2011) Extracapsular versus intracapsular allograft nephrectomy: impact on allosensitization and surgical outcomes. Can Urol Assoc J 5:49–52CrossRefPubMedPubMedCentral

38.

Eng MM, Power RE, Hickey DP, Little DM (2006) Vascular complications of allograft nephrectomy. Eur J Vasc Endovasc Surg 32:212–216CrossRefPubMed

39.

Sienko J, Tejchman K, Cnotliwy M, Falkowski A, Nowacki M, Ostrowski M (2006) Crossed bypass femoro-femoralis in patient with external iliac artery occlusion in the course of septic hemorrhage after renal graft explantation. Ann Transplant 11:12–14PubMed

40.

McIntosh BC, Bakhos CT, Sweeney TF, DeNatale RW, Ferneini AM (2005) Endovascular repair of transplant nephrectomy external iliac artery pseudoaneurysm. Conn Med 69:465–466PubMed

41.

Siddiqui AC, Lew SQ, Sarin S, Venbrux AC (2012) Emergency endovascular stenting of the right iliac artery in a patient with secondary haemorrhage following transplant nephrectomy. BMJ Case Rep 2012: bcr0220125827

42.

Ayus JC, Achinger SG, Lee S, Sayegh MH, Go AS (2010) Transplant nephrectomy improves survival following a failed renal allograft. J Am Soc Nephrol 21:374–380CrossRefPubMedPubMedCentral

43.

Casey MJ, Wen X, Kayler LK, Aiyer R, Scornik JC, Meier-Kriesche HU (2014) Prolonged immunosuppression preserves nonsensitization status after kidney transplant failure. Transplantation 98:306–311CrossRefPubMedPubMedCentral

44.

Lachmann N, Schonemann C, El-Awar N, Everly M, Budde K, Terasaki PI, Waiser J (2016) Dynamics and epitope specificity of anti-human leukocyte antibodies following renal allograft nephrectomy. Nephrol Dial Transplant 31:1351–1359CrossRefPubMed

45.

Sener A, Khakhar AK, Nguan CY, House AA, Jevnikar AM, Luke PP (2011) Early but not late allograft nephrectomy reduces allosensitization after transplant failure. Can Urol Assoc J 5:E142–E147CrossRefPubMedPubMedCentral

46.

Del Bello A, Congy-Jolivet N, Sallusto F, Guilbeau-Frugier C, Cardeau-Desangles I, Fort M, Esposito L, Guitard J, Cointault O, Lavayssiere L, Nogier MB, Blancher A, Rostaing L, Kamar N (2012) Donor-specific antibodies after ceasing immunosuppressive therapy, with or without an allograft nephrectomy. Clin J Am Soc Nephrol 7:1310–1319CrossRefPubMedPubMedCentral

47.

Douzdjian V, Rice JC, Carson RW, Gugliuzza KK, Fish JC (1996) Renal retransplants: effect of primary allograft nephrectomy on early function, acute rejection and outcome. Clin Transpl 10:203–208

48.

Ahmad N, Ahmed K, Mamode N (2009) Does nephrectomy of failed allograft influence graft survival after re-transplantation? Nephrol Dial Transplant 24:639–642CrossRefPubMed

49.

Sumrani N, Delaney V, Hong JH, Daskalakis P, Sommer BG (1992) The influence of nephrectomy of the primary allograft on retransplant graft outcome in the cyclosporine era. Transplantation 53:52–55CrossRefPubMed

50.

Kosmoliaptsis V, Gjorgjimajkoska O, Sharples LD, Chaudhry AN, Chatzizacharias N, Peacock S, Torpey N, Bolton EM, Taylor CJ, Bradley JA (2014) Impact of donor mismatches at individual HLA-A, -B, -C, -DR, and -DQ loci on the development of HLA-specific antibodies in patients listed for repeat renal transplantation. Kidney Int 86:1039–1048CrossRefPubMed

51.

Wang K, Xu X, Fan M, Qianfeng Z (2016) Allograft nephrectomy vs. no-allograft nephrectomy for renal transplantation: a meta-analysis. Clin Transpl 30:33–43CrossRef

52.

Augustine JJ, Woodside KJ, Padiyar A, Sanchez EQ, Hricik DE, Schulak JA (2012) Independent of nephrectomy, weaning immunosuppression leads to late sensitization after kidney transplant failure. Transplantation 94:738–743CrossRefPubMed

53.

Woodside KJ, Schirm ZW, Noon KA, Huml AM, Padiyar A, Sanchez EQ, Sarabu N, Hricik DE, Schulak JA, Augustine JJ (2014) Fever, infection, and rejection after kidney transplant failure. Transplantation 97:648–653PubMed

54.

Gregoor PJ, Kramer P, Weimar W, van Saase JL (1997) Infections after renal allograft failure in patients with or without low-dose maintenance immunosuppression. Transplantation 63:1528–1530CrossRefPubMed

55.

56.

Bayliss GP, Gohh RY, Morrissey PE, Rodrigue JR, Mandelbrot DA (2013) Immunosuppression after renal allograft failure: a survey of US practices. Clin Transpl 27:895–900CrossRef

Title: Graft nephrectomy in children
Authors: Benedict L. Phillips
Chris J. Callaghan
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 6/2018
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-017-3697-1

At a glance: The STEP trials

Springer Medicine

Graft nephrectomy in children

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2018

Thrombotic microangiopathy and breastfeeding: where is the link? Answers

Outcome of renal transplantation in small infants: a match-controlled analysis

Immunogenicity of the meningococcal polysaccharide conjugate vaccine in pediatric kidney transplant patients

Kidney injury biomarkers 5 years after AKI due to pediatric cardiac surgery

African Pediatric Nephrology Guidebook

Klotho G-395A gene polymorphism: impact on progression of end-stage renal disease and development of cardiovascular complications in children on dialysis