Acute Rejection in Retransplant Patients Versus Primary Transplant Patients From Paired Donors.

An acute rejection is believed to occure more frequently in the retransplant patients group. Antibody-mediated rejection may have an adverse effect on graft outcome. Kidney retransplant is a best approach to treat patients with renal allograft failure that allows them to avoid the risk of morbidity and mortality, connected with a return to dialysis and it is now reported that 1-year graft survival rated for second kidney transplants approach those of primary transplantations. In order to eliminate the influence of donor type on the kidney transplantation results, only pairs of patients with common donor were included in the analysis which resulted in 33 pairs of patients, in which the control group stated primary graft recipients. The frequency of acute rejection during the follow-up period (2 years) was analysed. There were twice as many episodes of acute rejection in the second group than in the first group. All of the retransplant patients received an induction immunosuppressive therapy. In the control group, two patients that had an acute rejection episode did not receive induction therapy. All of the patients have survived the follow-up period. The graft failure was observed only in the second group. 5 patients had lost their kidney, including one loss due to acute rejection. Our data on kidney retransplantation show that an excellent outcomes with low risk of acute rejection episodes are attainable. However, that specific group of patients should always be evaluated with caution and proper immunosuppressive therapy should be administered.

Kalina Jedrzejko, Rafal Kieszek, Magdalena Kwapisz, Monika Bieniasz, Magdalena Nita, Artur Kwiatkowski

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