Our Summary

This research paper discusses the issue of kidney transplantation for patients with severe kidney disease. The number of patients waiting for a kidney transplant is increasing, leading to a greater demand than supply for donor kidneys. To address this problem, new strategies have been introduced to increase the number of available kidneys, leading to more transplants being performed each year. However, transplanted kidneys don’t last forever and many patients end up needing dialysis treatment again when the new kidney fails. Doctors then face the challenge of what to do with the failed kidney. One option is to remove it through surgery (a transplant nephrectomy), but this comes with its own risks and can impact the success of future transplants. The paper examines when to use this surgery, how it’s done, and the results it can bring.

FAQs

  1. What is a transplant nephrectomy and when is it used?
  2. What is the impact of a transplant nephrectomy on future kidney transplants?
  3. What strategies have been introduced to increase the number of available kidneys for transplantation?

Doctor’s Tip

A helpful tip a doctor might tell a patient about nephrectomy is to follow all post-operative care instructions carefully to ensure proper healing and recovery. This may include instructions on wound care, pain management, activity restrictions, and follow-up appointments. It is important to communicate any concerns or symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended for nephrectomy include:

  1. Patients with a failed kidney transplant: When a transplanted kidney fails and is no longer functioning properly, nephrectomy may be recommended to remove the non-functioning kidney.

  2. Patients with complications from a failed kidney transplant: Some patients may develop complications such as infection, bleeding, or cancer in the failed kidney, which may necessitate a nephrectomy.

  3. Patients with recurrent kidney infections: Patients who experience recurrent kidney infections that are not responsive to other treatments may be recommended for nephrectomy to prevent further complications.

  4. Patients with kidney tumors: If a patient develops a kidney tumor, nephrectomy may be recommended to remove the tumor and prevent it from spreading to other parts of the body.

  5. Patients with severe kidney damage: In some cases, patients may have severe kidney damage that cannot be treated with other methods, leading to the recommendation for nephrectomy.

  6. Patients with polycystic kidney disease: Patients with polycystic kidney disease may develop large, painful cysts in their kidneys, which may require nephrectomy to alleviate symptoms and prevent further complications.

Overall, nephrectomy is recommended for patients with severe kidney disease or complications from a failed kidney transplant when other treatments are not effective or when the risks of leaving the non-functioning kidney in place outweigh the benefits.

Timeline

Before nephrectomy:

  1. Patient is diagnosed with severe kidney disease and begins treatment to manage symptoms.
  2. Patient is evaluated for a kidney transplant and placed on the transplant waiting list.
  3. Patient undergoes various tests and screenings to determine eligibility for transplant surgery.
  4. Patient receives a donor kidney and undergoes transplant surgery.

After nephrectomy:

  1. Patient experiences complications or rejection of the transplanted kidney.
  2. Patient’s kidney function declines and they require dialysis treatment again.
  3. Doctors determine that the failed kidney needs to be removed through nephrectomy.
  4. Patient undergoes nephrectomy surgery to remove the failed kidney.
  5. Recovery period post-surgery, including monitoring for any complications.
  6. Patient may be placed back on the transplant waiting list for another kidney transplant if eligible.

What to Ask Your Doctor

  1. What are the reasons for recommending a nephrectomy in my case?
  2. What are the potential risks and complications associated with a nephrectomy?
  3. How will a nephrectomy impact my overall kidney function and health?
  4. What is the recovery process like after a nephrectomy?
  5. Will I still be a candidate for future kidney transplants after a nephrectomy?
  6. Are there any alternative treatments or options to consider before undergoing a nephrectomy?
  7. How experienced is the surgical team in performing nephrectomies?
  8. What is the long-term outlook for my kidney health after a nephrectomy?
  9. What are the chances of complications or adverse effects during or after the surgery?
  10. How will a nephrectomy affect my quality of life in the long run?

Reference

Authors: Gunawardena T, Ridgway D. Journal: Saudi J Kidney Dis Transpl. 2022 Sep 1;33(5):716-725. doi: 10.4103/1319-2442.389431. Epub 2023 Nov 7. PMID: 37955463