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Volume: 6 Issue: 4 November 2008 - Supplement - 1

FULL TEXT

RENAL RE-TRANSPLANTATION: IS IT JUSTIFIED?

There is a dispute about the justification of renal re-transplantation in the presence of organ shortage, and the concept that patients who have lost a transplanted kidney are widely recognized as a high risk for re-transplantation. This is a retrospective study of the outcome of renal re-transplantation (Re-Tx) and to find out if renal re-transplantation is justified. Between 1993 and December 2007, 815 kidney transplantation procedures were performed in our centre, 55 of these (7%) were Re-Tx. The medical records of these patients were reviewed. They were 30 males and 25 females, aged 10 to 62 years (mean 36 years), and nine of them were children. Kidney grafts were obtained from 33 living and 32 cadaveric donors. Induction immunosuppression was with ATG in 32, Simulect in 9 and Thymoglobulin in 2 and one with Zinapax.Patients were followed up for 12 months to 156 months. Post transplantation complications were in the form of: 19 instances of surgical complication, 12 episodes of acute rejection, and 2 cases of malignancy. Three recipients died with functioning graft at 4 months to 62 months after transplantation. Nine more grafts were lost at one day to 84 months after transplantation secondary to renal vessel thrombosis in 4, chronic dysfunction in 2, and Primary non function in 1, Post renal biopsy bleeding in 1 and graft infarction secondary to antiphospholipid syndrome in one recipient. It was observed in the present series that renal Re-Tx is associated with recipient survival rates which are similar, and graft survival rates which are 10-13 % lower than those in primary transplantation. These results are still quite reasonable to justify renal re-transplantation.



Volume : 6
Issue : 4
Pages : 132


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Hamed Alessa Organ Transplantation center, Ibn sina Hospital, Kuwait, Kuwait