Clinical study on kidney transplantation in polycystic kidney disease

Objective To study the outcome of kidney transplantation in autosomal dominant polycystic kidney disease(ADPKD).Methods Forty-three patients of ADPKD(ADPKD group)underwent kidney transplantation without removing original kidney.And 50 cases undergoing kidney transplantation for other di-seases were chosen as control group.Both groups were followed up during the research.The 1-year,3-year and 5-year survival rates of patients or kidney grafts and rejections were evaluated after kidney transplantation.The sizes of polycystic kidney and transplanted kidney were measured by B ultrasound and the complication was recorded in ADPKD group.Results In the ADPKD group,1-year,3-year and 5-year patient survival rates were 95.3 %,90.6 % and 90.6 %,while 1-year,3-year and 5-year kidney survival rates were 95.3 %,88.3 % and 83.7 %.In the control group,1-year,3-year and 5-year patient survival rates were 96.0 %,92.0 % and 90.0 %,while 1-year,3-year and 5-year kidney survival rates were 94.0 %,92.0 % and 88.0 %.No significant difference of the rates was observed between the two groups(P0.05).There was no significant difference in the incidence of acute rejection between the two groups(P0.05).The size of polycystic kidney shrank 3-6 months after transplantation and became steady 1 year after transplantation.And there was no obvious change in the size of polycystic kidney from 1 to 15 years after transplantation.The hematuria was gradually alleviated and disappeared in 7-10 days after transplantation.The gross hematuria was repeatedly observed in 12 cases in 5-10 weeks after transplantation and was cured by anti-infection.The blood pressure of ADPKD patients was efficiently controlled with drug after transplantation.The rate of urinary tract infections for ADPKD group was 40 %.Seven cases of 32 ADPKD patients combined with polycystic liver developed liver function damage after transplantation.Conclusion The satisfactory clinical results can be obtained without removing the original polycystic kidney.Careful monitoring of kidney function,hematuria and the urinary tract infections is needed after transplantation.