Immunologic and non-immunologic complications of a third kidney transplantation

Background/Aims: Patients who undergo repeat kidney transplantations (KTs) are considered at high risk for experiencing immunologic and non-immunolog-ic complications. In this study, we investigated the clinical outcomes, including medical and surgical complications, of patients who underwent a thir...

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Bibliographic Details
Published in:The Korean journal of internal medicine 2015-09, Vol.30 (5), p.657
Main Authors: Hyun Seon Kim, Jae Young Kim, Eun Jin Kang, Yoon Seok Choi, Ji Il Kim, In Sung Moon, Bum Soon Choi, Cheol Whee Park, Chul Woo Yang, Yong Soo Kim, Byung Ha Chung
Format: Article
Language:Korean
Subjects:
Allograft survival
Complication
Kidney transplantation
Retransplantation
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Summary:Background/Aims: Patients who undergo repeat kidney transplantations (KTs) are considered at high risk for experiencing immunologic and non-immunolog-ic complications. In this study, we investigated the clinical outcomes, including medical and surgical complications, of patients who underwent a third KT at our center. Methods: Between March 1969 and December 2012, a total of 2,110 KTs were per-formed at the Seoul St. Mary’s Hospital. Of them, we examined 11 patients who underwent a third KT, and investigated the allograft outcomes and complication rates. Results: The mean follow-up duration after KT was 72.4 ± 78.3 months. The mean age at KT was 38.2 ± 8.0 years, and seven patients (63.6%) were males. Nine patients (81.8%) underwent living-donor KT. A cross-match test yielded positive results in four of the nine patients, and all underwent pretransplant desensitization ther-apy. After KT, three patients (27.2%) showed delayed graft function. Acute rejec-tion developed in four patients (36.4%), and surgical complications that required surgical correction occurred in three patients. Allograft failure developed due to acute rejection (n = 3) or chronic rejection (n = 1) in four patients. Allograft surviv-al rates at 1, 5, and 10 years were 81.8%, 42.9%, and 42.9%, respectively; however, the allograft survival rate at 5 years was > 80% in patients who underwent KT only after results of the panel reactive antibody test became available. Conclusions: Thus, a third KT procedure may be acceptable, although aggressive pretransplant immune monitoring and patient selection may be required to re-duce the risks of acute rejection and surgical complications.
ISSN:1226-3303
2005-6648