Outcome of Patients after Third and Fourth Kidney Transplantation.
BACKGROUND
A debate exists whether patients after second graft loss should be considered for a third and subsequent graft. Hence, a retrospective analysis was undertaken to assess outcomes of patients who underwent third and fourth transplantation.


METHODS
A total number of 16 kidney transplantations, were included in the present study. Thirteen patients out of them underwent a third kidney transplantation and 3 were fourth graft recipients. Data and variables on patient and graft survival were retrieved and analyzed using Kaplan-Meier statistics. Postoperative complications were assessed and graded based on Clavien-Dindo classification.


RESULTS
Patient survival was 92.3% after 1 year and 76.9% after 5 years (third graft). One year censored graft survival was 100% and a 5-year graft survival was 74.1% (third graft), respectively. In the cases of fourth transplantation, graft survivals of 33.3% at 1 and 2 years were noted among 3 patients. All fourth graft recipients have survived during our observation time. The overall rate of postoperative surgical complications among third graft recipients was 46.2 and 66.7% among patients after fourth transplantation.


CONCLUSIONS
Results on third kidney transplantation showed satisfactory patient and graft survival with acceptable outcome.
Department of Urology, Charité University Hospital Berlin, Berlin, Germany.
Frank
F
Friedersdorff
Supuni
S
Patabendhi
Jonas
J
Busch
Carsten
C
Kempkensteffen
Fabian
F
Halleck
Tom Florian
TF
Fuller
Kurt
K
Miller
Robert
R
Peters
D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome