✦ Renal Failure Treatment

Nephrectomy (pre-transplant)

Q: Do both kidneys need to be removed before transplant?

Not always — unilateral or bilateral nephrectomy is performed only when native kidneys are causing specific problems requiring removal.

Q: When is nephrectomy done — before or after transplant?

Pre-transplant nephrectomy is performed weeks to months before transplantation; post-transplant nephrectomy is occasionally needed for complications. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Q: Will removing my kidneys affect the transplant operation?

No — the transplant kidney is placed in the iliac fossa; native nephrectomy does not interfere with the transplant operation.

Removal of Failed Native Kidneys Before or After Renal Transplantation

90–150 min PROCEDURE

2–4 Days HOSPITAL STAY

>98% SUCCESS RATE

2–4 Weeks RECOVERY

What is Nephrectomy (pre-transplant)?

Pre-transplant Nephrectomy removes the failed native kidneys when they are causing ongoing problems that interfere with transplantation or post-transplant management. Indications include uncontrollable hypertension from renin-secreting native kidneys, recurrent pyelonephritis, polycystic kidneys too large to accommodate a transplant, persistent heavy proteinuria, or suspicion of malignancy. Nephrectomy is performed laparoscopically in most cases, often bilaterally if required. The procedure is performed under general or spinal anaesthesia with a hospital stay of 2–4 Days. Success rates reach >98% in appropriately selected patients at experienced centres.

Transplant candidates with problematic native kidneys causing hypertension, recurrent infection, space constraints from polycystic disease, or malignancy risk. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Port Placement

Laparoscopic ports placed; retroperitoneal or transperitoneal approach selected.

Kidney Mobilisation

Native kidney mobilised within Gerota's fascia; adrenal gland preserved.

Vessel Ligation

Renal artery and vein individually ligated and divided.

Ureteral Division

Ureter identified and divided proximally.

Specimen Extraction

Kidney placed in extraction bag and removed through enlarged port site.

Outcomes

90–150 minDURATION

2–4 DaysHOSPITAL STAY

>98%SUCCESS RATE

2–4 WeeksFULL RECOVERY

Who Needs This Treatment?

→Eliminates renin-mediated hypertension from failed native kidneys.
→Removes source of recurrent pyelonephritis protecting transplant outcomes.
→Creates retroperitoneal space for transplant kidney in polycystic disease.
→Laparoscopic approach provides rapid recovery before transplantation.
→Eliminates persistent proteinuria complicating immunosuppression management.
→Allows histological assessment of native kidneys for malignancy risk.

"Pre-transplant nephrectomy removes obstacles to successful transplantation. Whether controlling hypertension, eliminating infection, or making space for a polycystic kidney, it sets the stage for the best possible transplant outcome."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

Do both kidneys need to be removed before transplant?+

When is nephrectomy done — before or after transplant?+

Will removing my kidneys affect the transplant operation?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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