title: Kidney transplantation in patients declined by other centres.
abstract: BACKGROUND
  Transplant centres show considerable disagreement in the acceptance of transplant candidates with relative contraindications. The aim of this study is to investigate the outcomes of our patients who had been refused at other centres prior to transplantation at our centre.
  
  
  METHODS
  We included patients who had been excluded from transplantation or wait-listing at other centres before referral to our centre. We scored the reasons for refusal at other centres, the type of transplantation procedure, postoperative and long-term complications, patient and graft survival and how these patients experienced the transplantation and quality of life at our centre. All regular patients transplanted in 2010 functioned as a control group for outcome parameters.
  
  
  RESULTS
  We identified 23 patients in the period from January 2000 until March 2013. The most frequent reason for the refusal at other centres was obesity. Twenty of the 23 patients (87%) were alive and 19 had a functioning graft (83%) after a median follow-up of 21.0 months after transplantation (range 11.0-48.9). There were significantly more wound-related problems in the study group as compared with the control group (p = 0.029), but their kidney function at one year after transplantation was not significantly different. The patients indicated an improvement of quality of life after transplantation and in general were satisfied with the transplantation.
  
  
  CONCLUSIONS
  Patients who had previously had been denied transplantation at other centres generally did well after kidney transplantation with an increased risk of wound complications but a satisfactory graft and patient survival.
authors.affiliation: Department of Internal Medicine, section Nephrology and Transplantation, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
authors.forename: N H P
authors.initials: NH
authors.lastname: Glijn
authors.forename: J I
authors.initials: JI
authors.lastname: Roodnat
authors.forename: F J
authors.initials: FJ
authors.lastname: Dor
authors.forename: M G
authors.initials: MG
authors.lastname: Betjes
authors.forename: W C
authors.initials: WC
authors.lastname: Zuidema
authors.forename: W
authors.initials: W
authors.lastname: Weimar
authors.forename: S P
authors.initials: SP
authors.lastname: Berger
mesh_terms: D000328:Adult; D000075202:Contraindications; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016079:Refusal to Treat / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome