[Nephrectomy of the transplanted kidney].

A total of 118 allograft nephrectomies (TX) were performed after 474 renal transplants (TR) (24.9%). 49.1% of the patients were immunosuppressed with azathioprine-prednisone (AZA-PRED) and 50.9% with cyclosporine-prednisone (CSA-PRED). Mean time to TX after returning to hemodialysis was 36.2 +/- 6.4 days (0-372). Acute rejection (33.1%) was the first cause of TX, followed by chronic rejection (26.3%), vascular complications (25.5%), recurrent renal disease (5.9%), non-functioning allograft (4.2%) and not clearly established cause (1.7%). The surgical technique was extracapsular in 70.3% of the cases and subcapsular in 29.7%. The mean post-TR time to TX was significantly greater (p < 0.01) for the subcapsular technique. The mean surgical time was 106 +/- 4.4 min (45-300). Post-TX morbidity was 34%. Hemorrhage (11.2%) was the most frequent complication. The rest of the complications were infection (10.4%), neurologic (5.4%), gastrointestinal (4.5%), pulmonary (3.6%), cardiovascular (2.7%), nerve lesions (2.7%), lymphocele (0.9%) and urinary fistula (0.9%). The post-TX mortality was 6.5% (7/118), although it was significantly lower in the patients immunosuppressed with CSA-PRED (1.6%) than in those treated with AZA-PRED (10.3%).