Objectives. Because the timing of the nephrectomy still remains unclear, we studied the complications and outcomes of unilateral nephrectomy and concomitant pre-emptive kidney transplant with living-donors (PKTLD) in patients with autosomal-dominant polycystic kidney disease (ADPKD).

Patients and methods. From our prospectively maintained database of living-donors transplantation, we identified patients with ADPKD and pre-emptive grafts. Unilateral nephrectomy was performed for urologic complications or massively enlarged kidney, based on clinical examination and CT evaluation. We compared the operative and postoperative outcomes between patients who had simultaneous unilateral nephrectomy and PKTLD (N+ group) and patients with PKTLD alone (N- group).

Results. We included 31 patients. In the 14 patients of the N+ group, 12 had nephrectomy for massively enlarged kidney and 2 for urologic complications. Surgery length was shorter (p< 0.05) and there were less blood losses (p = 0.036) in the N- group. We noted no significant differences regarding the analgesia titration, ischemia length, delayed graft function and hospital stay duration. We experienced no death. Complications were more severe in the N+ group (p = 0.032). No severe complications occurred in N- group.

Conclusion. Concomitant nephrectomy may be performed for ADPKD without compromising the graft function but morbidity is still an issue in this pre-emptive living-donor transplantation context.

CITATION INFORMATION: Michel C, Audenet F, Ariane M, Legendre C, Joly D, Méjean A, Timsit M.-O. Pre-Emptive Kidney Transplantation with Living- Donor and Concomitant Unilateral Nephrectomy in Patients with Autosomal-Dominant Polycystic Kidney Disease: A Safe Strategy? Am J Transplant. 2016;16 (suppl 3).

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