Trends in the Management and Outcomes of Kidney Transplantation for Autosomal Dominant Polycystic Kidney Disease

Background. Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic disorder leading to end-stage renal failure. The objective of this study was to evaluate a longitudinal experience of kidney transplantation for ADPKD. Methods. A single center retrospective review of patient...

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Main Authors: Madhukar S. Patel, Praveen Kandula, David Wojciechowski, James F. Markmann, Parsia A. Vagefi
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Journal of Transplantation
Online Access:http://dx.doi.org/10.1155/2014/675697
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author Madhukar S. Patel
Praveen Kandula
David Wojciechowski
James F. Markmann
Parsia A. Vagefi
author_facet Madhukar S. Patel
Praveen Kandula
David Wojciechowski
James F. Markmann
Parsia A. Vagefi
author_sort Madhukar S. Patel
collection DOAJ
description Background. Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic disorder leading to end-stage renal failure. The objective of this study was to evaluate a longitudinal experience of kidney transplantation for ADPKD. Methods. A single center retrospective review of patients undergoing kidney transplantation was conducted, with comparisons across two time periods: early (02/2000–04/2007, n=66) and late (04/2007–08/2012, n=67). Results. Over the 13.5-year study period, 133 patients underwent transplantation for ADPKD. Overall, no significant difference between the early and late group with regard to intraoperative complications, need for reoperation, readmissions within 30 days, delayed graft function, and mortality was noted. There was a trend towards increase in one-year graft survival (early 93.1% versus late 100%, P=0.05). In the early group, 67% of recipients had undergone aneurysm screening, compared to 91% of recipients in the late group (P<0.001). Conclusions. This study demonstrates consistent clinical care with a trend towards improved rates of one-year graft survival. Interestingly, we also note a significantly higher use of cerebral imaging over time, with the majority that were detected requiring surgical intervention which may justify the current practice of nonselective radiological screening until improved screening criteria are developed.
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spelling doaj-art-7e5c60f6ffe4427f92ea4b68cc7893942025-08-20T03:35:34ZengWileyJournal of Transplantation2090-00072090-00152014-01-01201410.1155/2014/675697675697Trends in the Management and Outcomes of Kidney Transplantation for Autosomal Dominant Polycystic Kidney DiseaseMadhukar S. Patel0Praveen Kandula1David Wojciechowski2James F. Markmann3Parsia A. Vagefi4Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 544b, Boston, MA 02114, USADepartment of Medicine, Saint Barnabas Medical Center, Livingston, NJ 07039, USADepartment of Medicine, University of California, San Francisco, San Francisco, CA 94143, USADepartment of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 544b, Boston, MA 02114, USADepartment of Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 544b, Boston, MA 02114, USABackground. Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic disorder leading to end-stage renal failure. The objective of this study was to evaluate a longitudinal experience of kidney transplantation for ADPKD. Methods. A single center retrospective review of patients undergoing kidney transplantation was conducted, with comparisons across two time periods: early (02/2000–04/2007, n=66) and late (04/2007–08/2012, n=67). Results. Over the 13.5-year study period, 133 patients underwent transplantation for ADPKD. Overall, no significant difference between the early and late group with regard to intraoperative complications, need for reoperation, readmissions within 30 days, delayed graft function, and mortality was noted. There was a trend towards increase in one-year graft survival (early 93.1% versus late 100%, P=0.05). In the early group, 67% of recipients had undergone aneurysm screening, compared to 91% of recipients in the late group (P<0.001). Conclusions. This study demonstrates consistent clinical care with a trend towards improved rates of one-year graft survival. Interestingly, we also note a significantly higher use of cerebral imaging over time, with the majority that were detected requiring surgical intervention which may justify the current practice of nonselective radiological screening until improved screening criteria are developed.http://dx.doi.org/10.1155/2014/675697
spellingShingle Madhukar S. Patel
Praveen Kandula
David Wojciechowski
James F. Markmann
Parsia A. Vagefi
Trends in the Management and Outcomes of Kidney Transplantation for Autosomal Dominant Polycystic Kidney Disease
Journal of Transplantation
title Trends in the Management and Outcomes of Kidney Transplantation for Autosomal Dominant Polycystic Kidney Disease
title_full Trends in the Management and Outcomes of Kidney Transplantation for Autosomal Dominant Polycystic Kidney Disease
title_fullStr Trends in the Management and Outcomes of Kidney Transplantation for Autosomal Dominant Polycystic Kidney Disease
title_full_unstemmed Trends in the Management and Outcomes of Kidney Transplantation for Autosomal Dominant Polycystic Kidney Disease
title_short Trends in the Management and Outcomes of Kidney Transplantation for Autosomal Dominant Polycystic Kidney Disease
title_sort trends in the management and outcomes of kidney transplantation for autosomal dominant polycystic kidney disease
url http://dx.doi.org/10.1155/2014/675697
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