OBJECTIVES: Kidney transplant may be a good choice to treat chronic renal failure even in patients with two or more previous renal grafts. However, there might be several surgical complications and other difficulties we have to deal with. The aim of this report is to analyze the third, fourth and fifth transplants performed in our center focusing on the surgical complications and graft and patient survivals. METHODS: We performed a retrospective analysis of the 73 third, fourth and fifth kidney transplants performed in our center between February 1975 and December 2015. Statistical analysis has been performed with IBM SPSS 23.0 software. RESULTS: 62 patients received a third graft, 10 received a fourth one and one patient received a fifth graft. The median age of the recipients was 48 years, while for donors it was 50. Median cold ischemia time was 21 hours. Transplantectomy was not necessary in 49.31% of the cases. In 59.7% of the cases the graft vessels were anastomosed to the external iliac vessels. There were 21 cases of relevant postoperative complications (27.4% of the total grafts). Vascular thrombosis appeared in 5.5%. After 49 months of follow-up, the 1-, 3-, and 5-year graft survival were 64.3%, 56.16% and 50.69%, respectively. CONCLUSIONS: A new renal transplant in patients with two or more previous grafts is feasible, being necessary to individualize the cases. In spite of being more complex operations than previous transplants with a higher complication rate, we can obtain both acceptable graft and patient survival outcomes with an appropriate approach.
OBJECTIVES: Kidney transplant may be a good choice to treat chronic renal failure even in patients with two or more previous renal grafts. However, there might be several surgical complications and other difficulties we have to deal with. The aim of this report is to analyze the third, fourth and fifth transplants performed in our center focusing on the surgical complications and graft and patient survivals. METHODS: We performed a retrospective analysis of the 73 third, fourth and fifth kidney transplants performed in our center between February 1975 and December 2015. Statistical analysis has been performed with IBM SPSS 23.0 software. RESULTS: 62 patients received a third graft, 10 received a fourth one and one patient received a fifth graft. The median age of the recipients was 48 years, while for donors it was 50. Median cold ischemia time was 21 hours. Transplantectomy was not necessary in 49.31% of the cases. In 59.7% of the cases the graft vessels were anastomosed to the external iliac vessels. There were 21 cases of relevant postoperative complications (27.4% of the total grafts). Vascular thrombosis appeared in 5.5%. After 49 months of follow-up, the 1-, 3-, and 5-year graft survival were 64.3%, 56.16% and 50.69%, respectively. CONCLUSIONS: A new renal transplant in patients with two or more previous grafts is feasible, being necessary to individualize the cases. In spite of being more complex operations than previous transplants with a higher complication rate, we can obtain both acceptable graft and patient survival outcomes with an appropriate approach.
Authors: Rocío Santos-Pérez de la Blanca; José Medina-Polo; Elena Peña-Vallejo; Manuel Pamplona-Casamayor; Julio Teigell-Tobar; Mario Hernández-Arroyo; José Manuel Duarte-Ojeda; Ángel Tejido-Sánchez; Fernando Cabrera-Meiras; Natalia Miranda-Utrera; Lucía García-González; Esther González-Monte; Alfredo Rodríguez-Antolín Journal: Int Urol Nephrol Date: 2021-03-06 Impact factor: 2.370
Authors: Miriam C Banas; Georg A Böhmig; Ondrej Viklicky; Lionel P Rostaing; Thomas Jouve; Lluis Guirado; Carme Facundo; Oriol Bestard; Hermann-Josef Gröne; Kazuhiro Kobayashi; Vladimir Hanzal; Franz Josef Putz; Daniel Zecher; Tobias Bergler; Sindy Neumann; Victoria Rothe; Amauri G Schwäble Santamaria; Eric Schiffer; Bernhard Banas Journal: Front Med (Lausanne) Date: 2022-01-07
Authors: Shaifali Sandal; JiYoon B Ahn; Dorry L Segev; Marcelo Cantarovich; Mara A McAdams-DeMarco Journal: Am J Transplant Date: 2021-08-23 Impact factor: 8.086