Year : 2002 | Volume
: 19 | Issue : 1 | Page : 68--72
Graft nephrectomy: The SGPGI experience
Nand Kishore Arvind, Aneesh Srivastava, Anant Kumar, Subodh K Das
Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
Background: Graft nephrectomy is often considered a hazardous procedure with high morbidity and occasional mortality, and this may pose a technical challenge. The aim of this study was to evaluate the indications, etiology and complications following graft nephrectomy.
Materials and Methods: From 1988 to 2001, among total of 1,019 live related renal transplants carried at our center, 46 underwent graft nephrectomy. Patients were divided into 2 groups depending on timing of graft removal. The early group included 27 patients (within 2 months of transplantation) while in late group (graft removal after 2 months of transplantation) there were 19 patients. The 2 groups were compared in terms of indication, etiology and complications.
Results: In early group the indications for graft removal were acute rejection, thrombosis/infarction and hyperacute rejection, while in late group the indications were pain, hematuria, fever, hypertension and infection along with chronic failure. Overall, the external iliac artery injury occurred in I and 4 patients in early and late group respectively. Major blood loss occurred in I and 6 patients in early and late graft removal respectively. There were 2 deaths in early group due to ftdminant pneumonitis that progressed to sepsis and disseminated intravascular coagulation. There were 9 major wound infections all in early group except in 2 patients of late group. Respiratory infections occurred in 14 patients in early group and 1 in late group. In early group patients had CNS complications in form of seizures, clinical depression and delusional psychosis in 12 patients.
Conclusions: Our experience highlights the risk involved in graft nephrectomies. Severe acute rejection and thrombosis lead to early graft nephrectomies. Pain, hematuria, infection and hypertension in setting of chronic rejection are predominant causes for the delayed graft ne phrectomies. Early graft nephrectomy, though technically easy, is associated with systemic complications; late graft nephrectomy is technically more demanding with relatively increased risk of vascular and visceral injuries.
Department of Urology, SGPGIMS, Lucknow - 226 014
|How to cite this article:|
Arvind NK, Srivastava A, Kumar A, Das SK. Graft nephrectomy: The SGPGI experience.Indian J Urol 2002;19:68-72
|How to cite this URL:|
Arvind NK, Srivastava A, Kumar A, Das SK. Graft nephrectomy: The SGPGI experience. Indian J Urol [serial online] 2002 [cited 2021 Jun 23 ];19:68-72
Available from: https://www.indianjurol.com/article.asp?issn=0970-1591;year=2002;volume=19;issue=1;spage=68;epage=72;aulast=Arvind;type=0