The clinical analysis about surgical excision of polycystic kidney during kidney transplantation in uremic patients

Objective To investigate the merit and demerit for surgical excision of polycystic kidney at the same time of kidney transplantation and to analyze its effect on complications and prognosis.Methods The data of 63 cases of polycystic kidney were retrospectively analyzed.Among the 63 recipients,43 recipients were combined with polycystic liver,and 2 with pancreatic cyst.For the large size of polycystic kidney,in 31 patients with hematuria or urinary tract infection,the polycystic kidney was resected during kidney transplantation(kidney-cut group,31 cases).The polycystic kidneys in The remaining 32 cases were preserved during kidney transplantation (reservation group).All the recipients were treated with CsA(Tacrolimus),mycophenolate mofetil (MMF)and prednisone after transplantation.The general conditions of recipients,the occurrence of delayed graft function(DGF),acute graft rejection.operative complications and infection,and survival rate of recipients and grafts were observed.Results Operative time in kidney-cut group was (300±31)min,and perirenal drainage tube duration was(4.6±1.4)days in kidney-cut group,significantly longer than in reservation group(both P＜0.01).Volume of red blood cells transfusion in kidney-cut group was(4.31±1.05)U,significantly more than reservation group(P＜0.01).29.0%(9/31)recipients in kidney-cut group had surgical complications,significantly higher than reservation group(6.2 0A,2/32)(P＜0.05).The ineidence of urinary tract irdection was 31.2% (10/32)in reservation group,significantly higher than in kidney-cut group(6.5%,2/31,P＜0.05).12.5%(4/32)patients in reservation group needed surgical excision of polycystic kidney after kidney transplantation due to polycystic kidney infection.In 24 recipients with preoperative high blood pressure in each group,the blood pressure of 8 recipients(33.3%)in kidney-cut group returned to normal,compared with only 2 recipients(8.3%)in reservation group(P＜0.05).The incidence of DGF,incidence of acute rejection,human/kidney 1-and 5-year survival rate between 2 groups had no statistically significant difference.Conclusion As long as the detailed operation.it is safe to resect patient's polycystic kidney during renal transplantation,but there are no effects on patient/kidney survival rate. Key words: Polycystie kidney disease; Kidney transplantation; Postoperative complications