Date: Tuesday, May 5, 2015
Session Time: 4:00pm-5:30pm
Presentation Time: 5:12pm-5:24pm
Location: Room 115-AB
Introduction: For patients who have lost their first renal graft, a second kidney transplant is widely accepted as the next best therapeutic option (due to similar graft survival rates). This study investigates patient and graft outcomes following 3rd, 4th and 5th renal transplants.
Methods: We reviewed all transplants performed between 2000 and 2014 at our Unit. 1st and 2nd transplants (Group 1) were grouped together and compared with 3rd, 4th and 5th transplants (Group 2).
Results: There were 2951 renal transplants during the study period. 2895 were 1st and 2nd transplants (median age 44, IQR 21) and 56 (1.9%) were 3rd, 4th and 5th transplants (median age 43, IQR 17.75).
1150 (39.7%) recipients in Group 1 were female versus 28 (50%) in Group 2. Also 1379 (47.6%) donors in Group 1 were DBD, 427(14.7%) DCD and the rest from living donors. There were 27 (48.2%) DBD, 2 (3.6%) DCD and 27 (48.2%) living donors in Group 2.
The 1-, 3-, 5- and 10 year patient survival for Group 1 was 97.5, 95.7, 93.8 and 89.3% where as the graft survival for the same period was 94.7, 90.8, 83.3 and 32.3%. The 1-, 3-, 5- and 10 year patient survival for Group 2 was 96.3% 94.1% 94.1% and 87.4% where as the graft survival for the same period was 82.6% 80.2% 76.7% and 57.8% (p-values=0.811 and 0.854 respectively).
In 43 cases out of 49 (87.8%) where the information was available, at least one of the previous grafts was removed at some point. Moreover, in 21 out of 45 cases (46.7%), the common iliac artery was used for the new arterial anastomosis. In 8 out of 47 cases (17.0%) the new transplant was performed intraperitoneally.
Conclusions: Despite the surgical challenges associated with re-transplantation, performing a 3rd, 4th or 5th kidney transplant is feasible with comparable results in terms of short and long term patient and graft survival compared to patients who had their 1st and 2nd transplant.
To cite this abstract in AMA style:Loukopoulos I, Rompianesi G, Chandak P, Mamode N, Calder F, Kessaris N. Patient and Graft Outcomes Following 3rd, 4th and 5th Renal Transplants A Single Centre Comparative Study [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/patient-and-graft-outcomes-following-3rd-4th-and-5th-renal-transplants-a-single-centre-comparative-study/. Accessed January 17, 2020.
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