[Kidney transplantation with simultaneous nephrectomy: inappropriate or sensible?].

In conventional single kidney transplantation, the patient's kidneys are left in place. However, in certain patient collectives, the removal of the kidney may be indicated under some circumstances. This applies especially to patients whose own kidney may be a source of infection, bleeding, severe proteinuria and physical impairment due to a considerable increase in the kidney volume (cystic kidneys). Up until now, the procedure planned for either a bilateral nephrectomy after inclusion on the waiting list or a sequential procedure, which involves nephrectomy of one kidney and the removal of the other after kidney transplantation (sandwich technique). The concept presented here, kidney transplantation with concomitant ipsilateral nephrectomy is a safe procedure that leads to neither a significant increase in the incidence of surgical complications nor to a decrease in patient-and transplant survival. The major advantage of this method, in addition to a high measure of patient satisfaction, is the definitive surgical restoration of the kidney transplant recipient on the transplanted side with only one surgical intervention.