Third Kidney Transplantation: A Permanent Medical-Surgical Challenge

Blanco, Maria Diez; Medina, José M.; González, Esther; Domínguez, Manuel Fernández; Rodríguez, Antonia; Pamplona, M.; Andrès, Axel; Leiva, O; Morales, José

doi:10.1016/j.transproceed.2009.06.105

Cited by 22 publications

(26 citation statements)

References 14 publications

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“…Graft survival for 3rd/4th transplants in this study was 95% at 5 years compared with 83.1% in primary transplants and 85.6% for secondary transplants ( P = .35). This compares favorably with other studies which report 5‐year graft survival in three or more transplants of 42.9%‐78.1%, although many of these have a high number of deceased rather than living donors . As with other studies, the majority of graft loss was caused by rejection (5 of the 6), with one caused by early renal artery thrombosis; 50% of these graft losses required graft nephrectomy.…”

Section: Discussionsupporting

confidence: 76%

“…This is demonstrated in several studies that have shown increased operative times, blood loss, and vascular and ureteric complications. 7,9,11,13,23,24 In the biggest series to date, Ooms et al 11 complications were not significantly increased. A study by Kienzl-Wagner et al 7 analyzed 56 third or more kidney transplants and also reported higher rates of surgical complications, although blood loss and anastomotic times were not specifically described.…”

Section: Discussionmentioning

confidence: 93%

“…Repeat surgery to the iliac fossa is technically challenging. This is demonstrated in several studies that have shown increased operative times, blood loss, and vascular and ureteric complications . In the biggest series to date, Ooms et al describe 99 patients that received ipsilateral iliac fossa retransplantation.…”

Section: Discussionmentioning

confidence: 98%

See 2 more Smart Citations

Kidney retransplantation from HLA‐incompatible living donors: A single‐center study of 3rd/4th transplants

Barnes

Goodyear

Imray

et al. 2017

Clinical Transplantation

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

Kidney retransplantation from HLA‐incompatible living donors: A single‐center study of 3rd/4th transplants

Barnes

Goodyear

Imray

et al. 2017

Clinical Transplantation

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“…They reported 26.6% surgical complications. Graft survival at 1, 5, and 10 years were 87%, 76%, and 57%, respectively (13). Kienzl-Wagner and coworkers analyzed 56 third and fourth kidney transplants.…”

Section: Discussionmentioning

confidence: 99%

Kidney Retransplantation in the Ipsilateral Iliac Fossa: A Surgical Challenge

Ooms

Roodnat

Dor

et al. 2015

American Journal of Transplantation

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The aim of this study is to review the surgical outcome of kidney retransplantation in the ipsilateral iliac fossa in comparison to first kidney transplants. The database was screened for retransplantations between 1995 and 2013. Each study patient was matched with 3 patients with a first kidney transplantation. Just for graft and patient survival analyses, we added an extra control group including all patients receiving a second transplantation in the contralateral iliac fossa. We identified 99 patients who received a retransplantation in the ipsilateral iliac fossa. There was significantly more blood loss and longer operative time in the retransplantation group. The rate of vascular complications and graft nephrectomies within 1 year was significantly higher in the study group. The graft survival rates at 1 year and 3, 5, and 10 years were 76%, 67%, 61%, and 47% in the study group versus 94%, 88%, 77%, and 67% (p < 0.001) in the first control group versus 91%, 86%, 78%, and 57% (p ¼ 0.008) in the second control group. Patient survival did not differ significantly between the groups. Kidney retransplantation in ipsilateral iliac fossa is surgically challenging and associated with more vascular complications and graft loss within the first year after transplantation. Whenever feasible, the second renal transplant (first retransplant) should be performed contralateral to the prior failed one.

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“…Our patient did not have any procoagulant situation (no proteinuric state, no atrial fibrillation, no coagulopathy nor malignant neoplasia). In early arterial or vein thrombosis, treatment usually requires transplantectomy as shown by Blanco et al, (2009). However, as in native kidney infarction our patient was treated with systemic anticoagulation therapy.…”

Section: Discussionmentioning

confidence: 94%