Improving Outcomes after Allograft Nephrectomy through Use of Preoperative Angiographic Kidney Embolization.
J Am Coll Surg
; 234(4): 493-503, 2022 04 01.
Article
en En
| MEDLINE
| ID: mdl-35290268
ABSTRACT
BACKGROUND:
Allograft nephrectomy (AN) has been associated with considerable perioperative morbidity. We aimed to determine if preoperative angiographic kidney embolization (PAKE) to induce graft thrombosis before AN improves outcomes. STUDYDESIGN:
We reviewed adult kidney transplant alone patients who underwent AN at a single center from 2002 to 2020 and compared perioperative outcomes for patients with and without PAKE.RESULTS:
Eighty patients underwent AN, including 54 (67.5%) with PAKE before AN and 26 (32.5%) with AN alone. PAKE was associated with significantly reduced blood loss (PAKE mean 266 ± 292 mL vs AN alone 495 ± 689 mL; p = 0.04) and reduced transfusion requirements (PAKE mean 0.5 ± 0.8 packed red blood cell units vs AN alone 1.6 ± 2.6 units; p = 0.004) despite similar preoperative hemoglobin levels. Mean operating time (PAKE 142 ± 43 minutes vs AN alone 202 ± 111 minutes; p = 0.001) and length of hospital stay (PAKE 4.3 ± 2.0 days vs AN alone 9.3 ± 9.4 days; p = 0.0003) also favored PAKE, as did the surgical complication rate (PAKE 6/54 [11%] vs AN alone 9/26 [35%], p = 0.02). Long-term patient survival after AN was comparable in both groups.CONCLUSIONS:
PAKE was associated with lower intraoperative blood loss, fewer transfusions, reduced operating time, shorter length of stay, and fewer surgical complications compared with AN alone at our center.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Embolización Terapéutica
/
Nefrectomía
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
Idioma:
En
Año:
2022
Tipo del documento:
Article