Femoral neuropathy after kidney transplantation: A literature review of case reports and case series

Kidney transplant (KT) surgery can increase survival probability more than any other transplant. In this context, neurological complications could occur in an important percentage of individuals because this surgery is considered one of the most common organ transplantations. One rare type of neurological complication, which can occur after KT surgery, is the femoral motor neuropathy. We aimed to evaluate the clinical epidemiological profile and pathological mechanisms of femoral motor neuropathy after KT surgery. Relevant reports in six databases were identified and reviewed by two reviewers without language restriction. Seventeen reports of 183 cases from ten countries, more one unpublished case from our institution were assessed. The mean age was 39 years (range 5-69) with male sex (62.5%) and Asiatic origin predominance. The central primary kidney disease leading to renal failure was essential hypertension. The mean time from KT surgery to the onset of femoral neuropathy was 1.78 days, and the time from the occurrence of neuropathy to recovery was 6 months. The incidence of femoral neuropathy after KT surgery was 1.85%. The current review provides four possible mechanisms related to this complication, but maybe these explanations lead to a misunderstanding of the main risk factors for the development of femoral neuropathy. Furthermore, studies with current surgical techniques should be investigated because most of the data come from the old literature. Therefore, prospective studies and reports assessing the graft-recipient ratio and management options should be done.