title: Immediate re-transplantation following early kidney transplant thrombosis.
abstract: Allograft thrombosis is a devastating early complication of renal transplantation that ultimately leads to allograft loss. We report here on our experience of nine cases of immediate re-transplantation following early kidney transplant thrombosis at a single centre between January 1990 and June 2009. The mean age was 42.9 years at time of transplant. For seven patients, the allograft thrombosis was their first kidney transplant and seven of the nine cases had a deceased donor transplant. The initial transplants functioned for a mean of 1.67 days and the patients received a second allograft at a mean of 3.1 days after graft failure. All of the re-transplants worked immediately. Four allografts failed after a mean of 52.5 months (2-155 months). Two of these died with a functioning allograft, one failed owing to chronic allograft nephropathy and one owing to persistent acute cellular rejection. The remaining five patients still have a functioning allograft after a mean of 101.8 months (7-187 months). One year allograft and patient survival after re-transplantation were 87.5% and 100% respectively (after 5 years, both were 57%). Immediate re-transplantation following early kidney transplant thrombosis can be a success. It may be considered in selected cases after allograft thrombosis.
authors.affiliation: Department of Nephrology, Beaumont Hospital, Dublin, Ireland. paulphel@gmail.com
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Phelan
authors.forename: Colm
authors.initials: C
authors.lastname: Magee
authors.forename: Patrick
authors.initials: P
authors.lastname: O'Kelly
authors.forename: Frank
authors.initials: F
authors.lastname: J O'Brien
authors.forename: Dilly
authors.initials: D
authors.lastname: Little
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Conlon
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007494:Ireland; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000601:surgery*; D012082:Renal Veins / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013927:Thrombosis / Q000209:etiology / Q000601:surgery*; D013997:Time Factors; D017211:Treatment Failure; D020246:Venous Thrombosis / Q000209:etiology / Q000601:surgery*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents