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Master Thesis

Embolisation des reins polykystiques en alternative à la nephrectomie avant transplantation rénale : efficacité et suivi à long terme

Abstract : Purpose: To assess retrospectively the long-term outcomes of trans-arterial renal embolization (TAE) before renal transplantation in patients with polycystic kidney disease (PKD). Material and methods: Between January 2008 and November 2013, 76 kidneys (73 patients, mean age 53y, range: 34-72) were treated in 82 TAE procedures. Sixty-nine patients were under hemodialysis because of terminal stage PKD and 4 were on the renal transplant waiting list due to insufficient renal volume contrindicating kidney graft implantation. Volume reduction and post-graft survival rates are reported. Results: TAE was considered as successful in 89.5% of embolized kidneys (68/76). Peritoneal dialysis could be maintained in all patients using this dialysis technique. Post-embolization syndrome occurred after 15 procedures (18.3%). The severe complication rate was 4.9%. A significant volume reduction was observed at 3 months with a mean decrease of 40% (range: 2-69) and 59% (35 -86) thereafter (both, p<0.001). For 65 patients, temporary contraindications for grafts were resolved, on average 5.6 months after TAE (2.8-24.3). Of the 69 patients on the waiting list, 43 were successfully transplanted (67.7%). With a mean follow-up of 26.2 months (1.8-59.5), the 1-, 3- and 5-year survival rates after graft were all 95.3% (41/43) [95%CI: 82.7-98.8]. Estimated glomerular filtration rate (GFRs) over 30mL/min were 89.8% at 1 year [95%CI: 75-96.1], 89.8% at 3 years [95%CI: 75-96.1], and 62.7% at 5 years [95%CI: 29.6-83.6] after transplantation. Conclusions: Before transplantation, TAE is a safe and effective alternative to nephrectomy in patients with PKD.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01113660
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Submitted on : Friday, February 6, 2015 - 9:47:37 AM
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François Petitpierre. Embolisation des reins polykystiques en alternative à la nephrectomie avant transplantation rénale : efficacité et suivi à long terme. Médecine humaine et pathologie. 2014. ⟨dumas-01113660⟩

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