|
KMID : 0338420150300050657
|
|
The Korean Journal of Internal Medicine
2015 Volume.30 No. 5 p.657 ~ p.664
|
|
|
Immunologic and non-immunologic complications of a third kidney transplantation
|
|
:Kim Hyun-Seon
:Kim Jae-Young/:Kang Eun-Jin/:Choi Yoon-Seok/:Kim Ji-Il/:Moon In-Sung/:Choi Bum-Soon/:Park Cheol-Whee/:Yang Chul-Woo/:Kim Yong-Soo/:Chung Byung-Ha
|
|
|
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.
|
|
|
KEYWORD
|
|
|
Kidney transplantation, Retransplantation, Complication, Allograft survival
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
    
|
|