Outcome of Patients after Third and Fourth Kidney Transplantation

Urol Int. 2016;97(4):445-449. doi: 10.1159/000445216. Epub 2016 Jun 17.

Abstract

Introduction: A debate exists whether patients after second graft loss should be considered for a third and subsequent graft. Hence, a retrospective analysis was undertaken to assess outcomes of patients who underwent third and fourth transplantation.

Materials and methods: A total number of 16 kidney transplantations, were included in the present study. Thirteen patients out of them underwent a third kidney transplantation and 3 were fourth graft recipients. Data and variables on patient and graft survival were retrieved and analyzed using Kaplan-Meier statistics. Postoperative complications were assessed and graded based on Clavien-Dindo classification.

Results: Patient survival was 92.3% after 1 year and 76.9% after 5 years (third graft). One year censored graft survival was 100% and a 5-year graft survival was 74.1% (third graft), respectively. In the cases of fourth transplantation, graft survivals of 33.3% at 1 and 2 years were noted among 3 patients. All fourth graft recipients have survived during our observation time. The overall rate of postoperative surgical complications among third graft recipients was 46.2 and 66.7% among patients after fourth transplantation.

Conclusions: Results on third kidney transplantation showed satisfactory patient and graft survival with acceptable outcome.

MeSH terms

  • Graft Rejection
  • Graft Survival
  • Humans
  • Kidney Transplantation*
  • Postoperative Complications
  • Retrospective Studies
  • Treatment Outcome