Learning objectives
-to know the correlation between clinical signs and radiological findings in ADPKD waitlist candidates qualified for the native kidney nephrectomy (NKN).
-to emphasize the significance of routine pretransplant imaging for detecting clinically silent states.
-to improveclinical-radiological cooperation
Background
ADPKD is a well-recognised clinical entity, with a multisystemic phenotype, originating from PKD gene mutation[1]. The main clinical presentation is the cystic remodelling of the kidneys, leading to progressive deterioration in their function.
ADPKD is the tenth cause for the implementation of renal replacement therapy; the whose preferred form is kidney transplantation (KTx). Some of the ADPKD patients have unique needs regarding acceptance for the KTx.
Nearly 40% of patients require NKN in the peritransplant period[2]. Majority of procedures are performed before transplantation.
Pretransplant nephrectomy...
Findings and procedure details
In this educational exhibit, we will review some typical radiological findings in different clinical scenarios, indicating the need for pretransplant NKN.
Massive kidney enlargement: limited space for the graft
Among ADPKD transplant candidates, there are significant individual differences regarding kidney size.[Fig.1] The remaining space in the abdominal cavity may be insufficient for graft implantation, which poses an obstacle for the surgeon as making the procedure technically difficult or impossible.
The incorrect, negative decision regarding qualification for the pretransplant NKN can contribute to an excessive rise...
Conclusion
Diagnostic imaging studies should be routinely used as an additional tool to assess the need for pretransplant NKN in ADPKD patients.
Personal information and conflict of interest
E. A. Banach-Ambroziak;Gdansk/PL -nothing to disclose
M. Jankowska;Gdansk/PL -nothing to disclose
Prof. A. Dębska-Ślizień;Gdansk/PL -nothing to disclose
Prof. E. Szurowska;Gdansk/PL -nothing to disclose
References
1.Torres,Vicente E,Peter C Harris,and Yves Pirson.“Autosomal Dominant Polycystic Kidney Disease.”
2.Jankowska,M.,I.Kuźmiuk-Glembin,P.Skonieczny,and A.Dębska-Ślizień. “Native Nephrectomy in Renal Transplant Recipients With Autosomal Dominant Polycystic Kidney Disease.”
3.Biancofiore,Gianni.“Postoperative Intra-Abdominal Pressure and Renal Function After Liver Transplantation.”
4.Hori,Shunta,Mitsuru Tomizawa,Fumisato Maesaka,Takuya Owari,Yosuke Morizawa, Yasushi Nakai,Makito Miyake,“Unexpected Presentation of Allograft Dysfunction Triggered by Page Kidney Phenomenon Immediately after Kidney Transplantation:A Case Report.”
5.Magistroni,Riccardo,Cristiana Corsi,Teresa Martí,and Roser Torra. 2018.“A Review of the Imaging Techniques for Measuring Kidney and Cyst Volume in Establishing Autosomal Dominant Polycystic Kidney Disease Progression.”
6.Spithoven,E.M.,van Gastel, M.D.A., Messchendorp,...