This study gives a comprehensive summary of the risks and advantages of transplantectomy in patients who have had an allograft fail. It also includes a rundown of associated issues, such as alloantibody sensitization after nephrectomy and immunosuppressive weaning. Transplant nephrectomy was associated with a high risk of morbidity and death. The most common causes of transplant nephrectomy morbidity (4.3 to 82%) were bleeding and infection. The mortality rate varied between 1.2 and 39%, with sepsis accounting for the majority of deaths. Transvascular graft embolization was characterized as a less invasive alternative approach for the therapy of symptomatic graft rejection, with lower consequences compared with transplantectomy.

The frequency of patients returning to dialysis after a failed transplant is rising. The significance of allograft nephrectomy in the therapy of asymptomatic transplant failure is still debatable, and it still depends on each institution’s standard clinical practice. Transvascular embolization, which is less invasive and has a reduced morbidity and death rate, might be used in asymptomatic patients.