Immediate re-transplantation: An audacious approach to early vascular renal transplant failure

Franco, Antônio; Santarelli, David Rodriguez; Sanz, J.Tapia; Muñoz, Carlos; Contreras, Javier Pérez

doi:10.1016/j.nefroe.2017.11.004

Cited by 1 publication

(3 citation statements)

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“…Rapid re‐transplantation was possible due to the prioritization of EGL patients on the transplant waiting list, and even though the results are not significant, these recipients may have been rapidly re‐transplanted due to their lower cPRA. Despite this, our cohort had a mean of 16 days between transplants, paling in comparison to two previously published works of immediate re‐transplantation after EGL by Phelan et al 19 and Franco et al 18,19 that had a much shorter waiting time (a mean of 4.7 days in both studies).…”

Section: Discussionmentioning

confidence: 52%

“…Based on the results obtained from our data, there does not seem to be an increased immunological risk in patients who received a rapid re‐transplantation. The Franco et al cohort had four out of four functional grafts at follow‐up, but this was only up to 19 months post‐transplantation 18 . In contrast, the Phelan et al cohort had a longer follow‐up time (20 years) but had more graft failure 19 .…”

Section: Discussionmentioning

confidence: 99%

“…There is conflicting evidence on whether immediate re‐transplantation is safer than waiting for a reliable anti‐HLA determination. There are two published reports on this subject; however, both cohorts are small, and no significant conclusions can be determined from them 18,19 …”

Section: Introductionmentioning

confidence: 99%

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Rapid re‐transplantation safety following early kidney graft loss

et al. 2021

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Introduction Early graft loss is a devastating kidney transplant complication associated with high mortality and an increased risk of sensitization to antigens from the failed graft. Moreover, if rapid re‐transplantation were to occur, given that the human leukocyte antigen antibodies identification may not be reliable until several weeks after transplantation, the recipient's immunological status would be uncertain. Hence, there could be an increased immunological risk. To date, there is no information on whether a rapid re‐transplantation after early graft loss, without a new reliable anti‐HLA determination, is safe. Methods We retrospectively analysed the number of rejections and the graft survival of re‐transplanted patients with early graft loss (defined as graft failure before 30 days from transplant) from our centre between June 2003 and November 2019. The studied population was divided into rapid re‐transplantation (performed within 30 days of early graft loss) and late re‐transplantation (performed beyond those 30 days). Results Forty‐seven patients were re‐transplanted after early graft loss. There were nine rapid re‐transplantation cases with an 89% five‐year graft survival and one antibody‐mediated rejection episode. Furthermore, we identified 38 cases of late re‐transplantation with a 69% five‐year graft survival, 4 T cell‐mediated, and 11 antibody‐mediated rejections. Conclusions Rapid re‐transplantation appears to be safe and does not entail increased rejection risk, nor does it impact long‐term graft survival when compared to late re‐transplantation.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%