[Problems associated with nephrectomy of transplanted kidneys].

Graft survival is not indefinite and a proportion of the failures must be removed. This study pretend to know the fate of failed renal transplant (RT) in the child, indication for transplant nephrectomy (TN) and morbidity involved. 96 RT were performed between 1985 and september 1994, during this time 31 grafts were lost: 71% immunologic causes, 13% relapse of original disease and 16% other reasons. Mean patient age and weight were 9 years and 27.3 kg, respectively. TN was performed in 28 (29%) and the most common indication was symptomatic rejection after withdrawal of immunosuppression (35.7%). Postoperative complications were diverse, including wound hematoma (13.6%), major hemorrhage (7%), fluid and electrolyte disorders (45.5) and 1 patient died (4.5%). Re-surgical approach was necessary in the 2 patients with major hemorrhage and 50% of the patients were in need of dialysis in the early postoperative. In this paper we appreciated that child with failed renal allograft could need TX in 90% of the cases, mainly because of symptomatic rejection. Furthermore, this procedure is more risky than simple native nephrectomy.