Monreal García de Vicuña F, Rubio Briones J, Caparrós Sariol J, Lagunas Pes M P, Vicente Rodríguez J
Servicio de Urología, Fundación Puigvert, IUNA., Barcelona, España.
Arch Esp Urol. 1996 Dec;49(10):1029-33.
To determine the need for nephrectomy prior to renal transplantation in patients with adult polycystic renal disease.
We reviewed the records of 54 (31 females, 23 males) of 62 patients with polycystic renal disease that had been treated at our center from 1951 to 1994. Eight of the earlier cases, whose complete clinical data were unavailable, were excluded from the study. The patients were classified into three groups: nephrectomized transplanted, nephrectomized non-transplanted and non-nephrectomized transplanted patients.
No patient had required nephrectomy due to a tumor. No surgical difficulty during transplantation had been reported in the non-nephrectomized patients. Nephrectomy had been performed in most of the cases for hematuria or preparatory to renal transplantation. The infections complications (11.76%) were resolved with antibiotic therapy.
In the absence of renal tumor and given the low prevalence of complicated cysts, in our view it is unnecessary to perform nephrectomy routinely prior to renal transplantation in patients with adult polycystic renal disease. Nephrectomy should be reserved for cases with severe cystic complications, such as severe intracystic hemorrhage, hematuria causing anemia, pyonephrosis, or patients with grossly enlarged kidneys in whom we suspect that technical difficulties might arise at the time of transplantation.
确定成人多囊肾病患者肾移植前是否需要进行肾切除术。
我们回顾了1951年至1994年在本中心接受治疗的62例多囊肾病患者中的54例（31名女性，23名男性）的记录。早期的8例病例因完整临床数据不可用而被排除在研究之外。患者被分为三组：肾切除术后移植组、肾切除术后未移植组和未行肾切除术的移植患者组。
没有患者因肿瘤而需要进行肾切除术。未行肾切除术的患者在移植过程中未报告手术困难。大多数病例进行肾切除术是为了治疗血尿或作为肾移植的准备。感染并发症（11.76%）通过抗生素治疗得到解决。
在没有肾肿瘤且复杂囊肿患病率较低的情况下，我们认为成人多囊肾病患者在肾移植前常规进行肾切除术是不必要的。肾切除术应保留给有严重囊性并发症的病例，如严重的囊内出血、导致贫血的血尿、肾积脓，或肾脏明显增大且我们怀疑移植时可能出现技术困难的患者。
