The Failing Kidney Transplant Allograft. Transplant Nephrectomy: Current State-of-the-Art
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 weani...
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| Veröffentlicht in: | Current urology reports 2020-01, Vol.21 (1), p.4-4, Article 4 |
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| creator | Gómez-Dos-Santos, Victoria Lorca-Álvaro, Javier Hevia-Palacios, Vital Fernández-Rodríguez, Ana María Diez-Nicolás, Victor Álvarez-Rodríguez, Sara Burgos, Jennifer Brasero Guerrero, Clara Sánchez Burgos-Revilla, Francisco Javier |
| description | 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. |
| doi_str_mv | 10.1007/s11934-020-0957-6 |
| format | Article |
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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.</description><identifier>ISSN: 1527-2737</identifier><identifier>EISSN: 1534-6285</identifier><identifier>DOI: 10.1007/s11934-020-0957-6</identifier><identifier>PMID: 31960160</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Allografts - surgery ; Graft Rejection - etiology ; Graft Rejection - surgery ; Humans ; Kidney Diseases (G Ciancio ; Kidney Transplantation - adverse effects ; Medicine ; Medicine & Public Health ; Nephrectomy - methods ; Nephrology ; Section Editor ; Topical Collection on Kidney Diseases ; Transplants - surgery ; Urology</subject><ispartof>Current urology reports, 2020-01, Vol.21 (1), p.4-4, Article 4</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c344t-6331e3cfc62b650d40e72541a901f8629b092fce06a6322ce8472c6e9fc85b553</citedby><cites>FETCH-LOGICAL-c344t-6331e3cfc62b650d40e72541a901f8629b092fce06a6322ce8472c6e9fc85b553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11934-020-0957-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11934-020-0957-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31960160$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gómez-Dos-Santos, Victoria</creatorcontrib><creatorcontrib>Lorca-Álvaro, Javier</creatorcontrib><creatorcontrib>Hevia-Palacios, Vital</creatorcontrib><creatorcontrib>Fernández-Rodríguez, Ana María</creatorcontrib><creatorcontrib>Diez-Nicolás, Victor</creatorcontrib><creatorcontrib>Álvarez-Rodríguez, Sara</creatorcontrib><creatorcontrib>Burgos, Jennifer Brasero</creatorcontrib><creatorcontrib>Guerrero, Clara Sánchez</creatorcontrib><creatorcontrib>Burgos-Revilla, Francisco Javier</creatorcontrib><title>The Failing Kidney Transplant Allograft. Transplant Nephrectomy: Current State-of-the-Art</title><title>Current urology reports</title><addtitle>Curr Urol Rep</addtitle><addtitle>Curr Urol Rep</addtitle><description>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.</description><subject>Allografts - surgery</subject><subject>Graft Rejection - etiology</subject><subject>Graft Rejection - surgery</subject><subject>Humans</subject><subject>Kidney Diseases (G Ciancio</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nephrectomy - methods</subject><subject>Nephrology</subject><subject>Section Editor</subject><subject>Topical Collection on Kidney Diseases</subject><subject>Transplants - surgery</subject><subject>Urology</subject><issn>1527-2737</issn><issn>1534-6285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kL1OwzAURi0EoqXwACwoI4vL9U-chK2qKCAqGCgDk-W6N22qNCm2M_TtcdWCmJhsfT730_Uh5JrBkAFkd56xQkgKHCgUaUbVCemzNCaK5-np_s4zyjOR9ciF92uIIOTynPQEKxQwBX3yOVthMjFVXTXL5KVaNLhLZs40flubJiSjum6XzpRh-Dd9xe3KoQ3tZnefjDvnMIbvwQSkbUnDCunIhUtyVpra49XxHJCPycNs_ESnb4_P49GUWiFloEoIhsKWVvG5SmEhATOeSmYKYGWueDGHgpcWQRklOLeYy4xbhUVp83SepmJAbg-9W9d-deiD3lTeYh03xbbzmgspQKpc7lF2QK1rvXdY6q2rNsbtNAO9N6oPRnUUpfdGtYozN8f6br7Bxe_Ej8II8APg41OzRKfXbeea-OV_Wr8B32GAHQ</recordid><startdate>20200118</startdate><enddate>20200118</enddate><creator>Gómez-Dos-Santos, Victoria</creator><creator>Lorca-Álvaro, Javier</creator><creator>Hevia-Palacios, Vital</creator><creator>Fernández-Rodríguez, Ana María</creator><creator>Diez-Nicolás, Victor</creator><creator>Álvarez-Rodríguez, Sara</creator><creator>Burgos, Jennifer Brasero</creator><creator>Guerrero, Clara Sánchez</creator><creator>Burgos-Revilla, Francisco Javier</creator><general>Springer US</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200118</creationdate><title>The Failing Kidney Transplant Allograft. Transplant Nephrectomy: Current State-of-the-Art</title><author>Gómez-Dos-Santos, Victoria ; Lorca-Álvaro, Javier ; Hevia-Palacios, Vital ; Fernández-Rodríguez, Ana María ; Diez-Nicolás, Victor ; Álvarez-Rodríguez, Sara ; Burgos, Jennifer Brasero ; Guerrero, Clara Sánchez ; Burgos-Revilla, Francisco Javier</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c344t-6331e3cfc62b650d40e72541a901f8629b092fce06a6322ce8472c6e9fc85b553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Allografts - surgery</topic><topic>Graft Rejection - etiology</topic><topic>Graft Rejection - surgery</topic><topic>Humans</topic><topic>Kidney Diseases (G Ciancio</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nephrectomy - methods</topic><topic>Nephrology</topic><topic>Section Editor</topic><topic>Topical Collection on Kidney Diseases</topic><topic>Transplants - surgery</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gómez-Dos-Santos, Victoria</creatorcontrib><creatorcontrib>Lorca-Álvaro, Javier</creatorcontrib><creatorcontrib>Hevia-Palacios, Vital</creatorcontrib><creatorcontrib>Fernández-Rodríguez, Ana María</creatorcontrib><creatorcontrib>Diez-Nicolás, Victor</creatorcontrib><creatorcontrib>Álvarez-Rodríguez, Sara</creatorcontrib><creatorcontrib>Burgos, Jennifer Brasero</creatorcontrib><creatorcontrib>Guerrero, Clara Sánchez</creatorcontrib><creatorcontrib>Burgos-Revilla, Francisco Javier</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Current urology reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gómez-Dos-Santos, Victoria</au><au>Lorca-Álvaro, Javier</au><au>Hevia-Palacios, Vital</au><au>Fernández-Rodríguez, Ana María</au><au>Diez-Nicolás, Victor</au><au>Álvarez-Rodríguez, Sara</au><au>Burgos, Jennifer Brasero</au><au>Guerrero, Clara Sánchez</au><au>Burgos-Revilla, Francisco Javier</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Failing Kidney Transplant Allograft. Transplant Nephrectomy: Current State-of-the-Art</atitle><jtitle>Current urology reports</jtitle><stitle>Curr Urol Rep</stitle><addtitle>Curr Urol Rep</addtitle><date>2020-01-18</date><risdate>2020</risdate><volume>21</volume><issue>1</issue><spage>4</spage><epage>4</epage><pages>4-4</pages><artnum>4</artnum><issn>1527-2737</issn><eissn>1534-6285</eissn><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.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31960160</pmid><doi>10.1007/s11934-020-0957-6</doi><tpages>1</tpages></addata></record> |
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| subjects | Allografts - surgery Graft Rejection - etiology Graft Rejection - surgery Humans Kidney Diseases (G Ciancio Kidney Transplantation - adverse effects Medicine Medicine & Public Health Nephrectomy - methods Nephrology Section Editor Topical Collection on Kidney Diseases Transplants - surgery Urology |
| title | The Failing Kidney Transplant Allograft. Transplant Nephrectomy: Current State-of-the-Art |
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