Living-Donor Kidney Re-Transplantation: Risk Factors and Long-Term Follow-up

Elbialy, Nour Elsabah Mohamed; Elokely, Amir Mohammed; Neamatallah, Ahmed Hasan; Ibrahim, Mohammed; Salem, Ibrahim

doi:10.21608/zumj.2022.147525.2595

Living-Donor Kidney Re-Transplantation: Risk Factors and Long-Term Follow-up

Document Type : Original Article

Authors

¹ Urology and Nephrology Center ,Mansoura University, Mansoura , Egypt

² internal medicine department,faculty of medicine,zagazig university,zagazig,egypt

³ Urology and Nephrology Center, Mansoura University Mansoura ,Egypt

⁴ Faculty of medicine ,Zagazig university

⁵ Internal Medicine Department , Faculty of medicine ,Zagazig University

10.21608/zumj.2022.147525.2595

Abstract

Introduction: Transplanting young and healthy individuals with ESRD maximizes survival outcome and saves money. Also Transplanting patients with co-morbidities is cost-effective and leads to significant survival outcome in comparison to the dialysis alternative.Although kidney re-transplantation is often accepted as the best choice for most patients subsequent to kidney allograft loss, there is surprisingly few data to support it. Our aim is to assess the outcome of living kidney re-transplantation and whether patients experiencing primary allograft loss should be offered the second renal allograft.Methods: Comparative cross-section study included 267 recipients of kidney transplant who underwent kidney allo-transplantation from March, 1976 till December,2015. These recipients were divided into two groups. Group1: All Patients who received 2nd kidney transplantation (90 patients).Group 2: Matched group of patients who received first kidney transplantation.Results: Both groups were comparable in their demographic data but recipient consanguinity (p=0.000), donor age (p =0.004) and gender(p=0.000) were not comparable. As for maintenance therapy, while the total dose of steroid was comparable (p=0.28) , the percentage of use of different immunosuppression protocols was significantly different in both groups(p=0.000). Regarding Post-transplant complications, no statistical difference has been found between both groups with regard to infections, hepatic impairment and malignancy (p < 0.05) while acute tubular injury incidence was higher in the study group (p=0.04).Conclusions: our study is considered as a push for patients who lose their first graft to undergo second transplantation without fear of any further complication. Re-transplantation is safe and comparable with primary transplantation in all risk factors and outcomes.

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