Immunologic and non-immunologic complications of a third kidney transplantation.
10.3904/kjim.2015.30.5.657
- Author:
Hyun Seon KIM
1
;
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
Author Information
1. Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. chungbh@catholic.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Kidney transplantation;
Retransplantation;
Complication;
Allograft survival
- MeSH:
Acute Disease;
Adult;
Allografts;
Chronic Disease;
Delayed Graft Function/diagnosis/*etiology/therapy;
Female;
Graft Rejection/diagnosis/*immunology/therapy;
Graft Survival;
*Histocompatibility;
Humans;
Immunosuppressive Agents/therapeutic use;
Kidney Transplantation/*adverse effects;
Male;
Middle Aged;
Patient Selection;
Reoperation;
Republic of Korea;
Risk Assessment;
Risk Factors;
Time Factors;
Treatment Outcome
- From:The Korean Journal of Internal Medicine
2015;30(5):657-664
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Patients who undergo repeat kidney transplantations (KTs) are considered at high risk for experiencing immunologic and non-immunologic 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 performed 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 therapy. After KT, three patients (27.2%) showed delayed graft function. Acute rejection 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 survival 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 reduce the risks of acute rejection and surgical complications.
