Successful 4th kidney transplantation: a case report from Iran

Area of Science:

• Nephrology
• Transplant Surgery
• Immunology

Background:

• Kidney transplantation is the preferred renal replacement therapy for end-stage renal disease.
• Graft failure necessitates re-transplantation, with outcomes varying by transplant number.

Observation:

• A 49-year-old male patient received his first kidney transplant at age 18.
• He underwent a successful fourth living-unrelated kidney transplant 31 years after his initial procedure.

Findings:

• The patient experienced no serious complications following his fourth kidney transplant.
• Excellent allograft function was maintained, with serum creatinine at 1.2 mg/dL 33 months post-transplant.

Implications:

• This case highlights the feasibility of multiple kidney re-transplantations.
• It suggests long-term graft survival is achievable even in advanced transplant cases.
• This represents the first reported instance of a fourth kidney transplant in Iran.