The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Immunologic and non-immunologic complications of a third kidney transplantation

  • Kim, Hyun Seon (Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Kim, Jae Young (Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Kang, Eun Jin (Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Choi, Yoon Seok (Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Kim, Ji-Il (Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Moon, In Sung (Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Choi, Bum Soon (Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Park, Cheol Whee (Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Yang, Chul Woo (Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Kim, Yong-Soo (Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Chung, Byung Ha (Transplant Research Center, Seoul St. Mary's Hospital, The Catholic University of Korea)
  • Received : 2014.04.11
  • Accepted : 2014.07.28
  • Published : 2015.09.01
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Abstract

Background/Aims: Patients who undergo repeat kidney transplantations (KTs) are considered at high risk for experiencing immunologic and non-immunologic complications. In this study, we investigated the clinical outcomes, including medical and surgical complications, of patients who underwent a third KT at our center. Methods: Between March 1969 and December 2012, a total of 2,110 KTs were performed at the Seoul St. Mary's Hospital. Of them, we examined 11 patients who underwent a third KT, and investigated the allograft outcomes and complication rates. Results: The mean follow-up duration after KT was $72.4{\pm}78.3months$. The mean age at KT was $38.2{\pm}8.0years$, and seven patients (63.6%) were males. Nine patients (81.8%) underwent living-donor KT. A cross-match test yielded positive results in four of the nine patients, and all underwent pretransplant desensitization therapy. After KT, three patients (27.2%) showed delayed graft function. Acute rejection developed in four patients (36.4%), and surgical complications that required surgical correction occurred in three patients. Allograft failure developed due to acute rejection (n = 3) or chronic rejection (n = 1) in four patients. Allograft survival rates at 1, 5, and 10 years were 81.8%, 42.9%, and 42.9%, respectively; however, the allograft survival rate at 5 years was > 80% in patients who underwent KT only after results of the panel reactive antibody test became available. Conclusions: Thus, a third KT procedure may be acceptable, although aggressive pretransplant immune monitoring and patient selection may be required to reduce the risks of acute rejection and surgical complications.

Keywords

Acknowledgement

Supported by : Ministry of Health and Welfare

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