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Abstract
<p class="first" id="d1376385e97">Patients with autosomal dominant polycystic disease
(ADPKD) may require bilateral
nephrectomy (BN) in addition to kidney transplantation (KT) for symptom control. This
study aims to compare simultaneous BNKT to contemporaneous controls by reviewing our
cohort of ADPKD patients who underwent KT from a living donor from January 2014 to
October 2019. Symptomatic patients who underwent laparoscopic BNKT were compared to
KT alone. Clinical differences related to undertaking bilateral nephrectomies showed
increased total kidney volumes (P < .001). We assessed operative parameters, complications,
and clinical outcomes. The complications were classified according to the Clavien-Dindo
system. In 148 transplant recipients, 51 underwent BNKT, and 97 KT alone. There was
no difference in baseline demographics. BNKT recipients had longer cold ischemia time,
required more ICU care, increased blood transfusions and longer hospital stays. The
kidney function was similar in the first year in both groups, with no difference in
delayed graft function, readmissions or severe grade III and IV complications within
3 months after surgery. Laparoscopic BNKT is safe and feasible at the time of living
donor KT. Although higher acuity care is needed with a longer initial hospital stay,
there are comparable posttransplant patient and allograft outcomes.
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