Immunologic and non-immunologic complications of a third kidney transplantation
The Korean Journal of Internal Medicine
;
: 657-664, 2015.
Article
in English
| WPRIM
| ID: wpr-76678
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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Reoperation
/
Time Factors
/
Acute Disease
/
Chronic Disease
/
Risk Factors
/
Kidney Transplantation
/
Treatment Outcome
/
Risk Assessment
/
Patient Selection
/
Delayed Graft Function
Type of study:
Etiology study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
The Korean Journal of Internal Medicine
Year:
2015
Type:
Article
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