Simultaneous nephrectomy, transplant offers advantages in polycystic kidney disease
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For patients with autosomal dominant polycystic kidney disease, undergoing bilateral nephrectomy and kidney transplantation in the same sitting led to cost savings and shorter hospital stays.
Findings of this retrospective single-center review were presented virtually at the American Society of Transplant Surgeons Winter Symposium.
“In patients with ADPKD, progressive enlargement of kidneys can lead to significant symptoms requiring nephrectomy prior to kidney transplant,” Andrew Rasmussen, MD, of Western University in Ontario, Canada, said. “There is an ongoing debate regarding the sequencing of nephrectomy and transplant with logistical issues and the complication profile remaining important considerations. There are, however, no published cost analyses or cost comparisons in the literature.”
For the study, researchers compared outcomes between patients in the staged group (or those who underwent bilateral nephrectomy and transplantation in separate sittings) and those in the simultaneous group (those who underwent both procedures in the same sitting).
“There was a significant difference in cost favoring the simultaneous group, with approximately $10,000 more cost in the staged group,” Rasmussen said of the findings. He noted this was primarily due to costs related to inpatient care and operative services, as patients in the simultaneous group also had shorter lengths of stay (8 days vs. 14.5 days).
No differences were observed between groups regarding complication rates.
“The simultaneous approach appears to be safe and may offer a cost advantage,” Rasmussen concluded. “Further study in the deceased donor transplant population is warranted.”
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Rasmussen A, et al. Poster 26. Presented at: ASTS Winter Symposium. Jan. 14-16, 2021 (virtual meeting).
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