Nephrectomy or No Nephrectomy?

A recent study in JASN Feb 2010 issue, a study reports that patients who have failed allografts and who return to dialysis and undergo allograft nephrectomy have improved survival as compared to patients that have retained the allografts. This is going to spring a lot of debate in Transplantation field as it was always thought that if you take out the allograft, you have more chances of making antibodies and you will have a higher risk of rejection.
The authors in this argue that being on low dose immunsuppresion along with dialysis might be more of an infectious and cardiovascular risk and hence worse outcomes.
Its a good paper and a good study to challenge the current notion. But do we take this to practice yet?
Probably not yet, this is retrospective, only medicare patients and a more methodological study needs to be done.
This is going to bring in a lot of debate. Looking forward to see what happens next