TRANSPLANT NEPHRECTOMY OVER 20 YEARS - FACTORS INVOLVED IN ASSOCIATEDMORBIDITY AND MORTALITY

Of 1,048 renal transplants performed between 1971 and 1990, transplant nephrectomy was performed in 86 (8.2%). Mean patient age was 33 years (range 3.8 to 66.5). Postoperative complications occurred in 60% of t he patients, including wound infection in 20% and major hemorrhage in 4 patients. The external iliac artery was ligated in 4 patients. The i ncidence and severity of the complications were greater in patients wi th acute rejection. Four patients died: 1 of ischemic bowel and metast atic carcinoma, 1 of pulmonary embolism, and 2 of sepsis and dissemina ted intravascular coagulation. The nephrectomy rate increased signific antly (p <0.005) when cyclosporine A was initially introduced. Added c are is necessary when new immunosuppressants are used. The majority of our failed transplants were left in situ without compromising overall patient well-being.