ESPN 51th Annual Meeting

ESPN 2018


 
NATIVE NEPHRECTOMY INDICATION, TIMING AND OUTCOME IN PAEDIATRIC KIDNEY TRANSPLANTATION
EMILY HASELER 1 C Senni 1 Massimo Garriboli 1 Jo Clothier 1

1- Department of nephro-urology, EVELINA LONDON CHILDRENS HOSPITAL
 
Introduction:

Native nephrectomy in paediatric kidney transplant recipients may be performed for a number of reasons.

This study aimed to establish whether the timing of nephrectomy (before, during or after transplantation) is associated with any difference in outcome.

Material and methods:

Single-centre, retrospective analysis of all recipients of kidney transplant over a 10 year period (January 2007 to January 2018). Patients divided in 3 groups: 1) native nephrectomy before transplant (BT), 2) during transplant (DT) or 3) after transplant (AT). Outcome measures at 1 year post-Tx: estimated GFR (eGFR), number of antihypertensive agents required, number of documented urinary tract infections (UTI). One-Way ANOVA used to explore significance among groups.

Results:

131 transplants performed.  Median age at transplant 11 years 5 months (range 19 -212 months). 55 (42%) patients underwent native nephrectomies (42 bilateral, 18 were simultaneous). 

Proteinuria and hypertension were the most common indications (32% and 22% respectively) for nephrectomy before transplant (BT), polyuria and UTI in DT (25% each) and AT (48% and 45% respectively) groups.

One-year outcome data available for 41 patients (17 BT, 7 DT and 17 AT).

Median eGFR (ml/min/1.73m2) was similar (p=0.11) between groups (49.9 in BT, 60.4 in DT, 55.0 in AT). Rate of UTI was higher for DT and AT groups (1.44 and 1.47, respectively) compared to 0.53 in the BT (p=0.14).  Number of antihypertensive agents required was higher in the DT group (mean 0.75) compared to BT and AT groups (0.22, and 0.35, respectively) however, did not reach statistical significance (p= 0.09).

Conclusions:

Native nephrectomy is common in our patient group. Timing of nephrectomy does not appear to influence eGFR at 1 year.