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Current Urology Reports
Published in: Current Urology Reports 1/2020

01-01-2020 | Nephrectomy | Kidney Diseases (G Ciancio, Section Editor)

The Failing Kidney Transplant Allograft. Transplant Nephrectomy: Current State-of-the-Art

Authors: Victoria Gómez-Dos-Santos, Javier Lorca-Álvaro, Vital Hevia-Palacios, Ana María Fernández-Rodríguez, Victor Diez-Nicolás, Sara Álvarez-Rodríguez, Jennifer Brasero Burgos, Clara Sánchez Guerrero, Francisco Javier Burgos-Revilla

Published in: Current Urology Reports | Issue 1/2020

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Abstract

Purpose of Review

This review provides a critical literature overview of the risks and benefits of transplantectomy in patients with a failed allograft. Additionally, it offers a summary of related problems, primarily alloantibody sensitization in the event of nephrectomy and immunosuppression weaning.

Recent Findings

Transplant nephrectomy has high morbidity and mortality rates. The morbidity of transplant nephrectomy (4.3 to 82%) is mostly due to hemorrhage or infection. Mortality rates range from 1.2 to 39%, and most are due to sepsis. Transvascular graft embolization has been described as a less invasive alternative technique for the management of symptomatic graft rejection, with minimal complications compared with transplantectomy.

Summary

The number of patients with a failed allograft returning to dialysis is increasing. The role of allograft nephrectomy in the management of asymptomatic transplant failure is still controversial and up today continues to depend on the usual clinical practice of each institution. The less invasive transvascular embolization could have applicability in asymptomatic patients with the obvious lower morbidity and mortality rate.
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Metadata
Title
The Failing Kidney Transplant Allograft. Transplant Nephrectomy: Current State-of-the-Art
Authors
Victoria Gómez-Dos-Santos
Javier Lorca-Álvaro
Vital Hevia-Palacios
Ana María Fernández-Rodríguez
Victor Diez-Nicolás
Sara Álvarez-Rodríguez
Jennifer Brasero Burgos
Clara Sánchez Guerrero
Francisco Javier Burgos-Revilla
Publication date
01-01-2020
Publisher
Springer US
Published in
Current Urology Reports / Issue 1/2020
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-020-0957-6

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