Outcome of Patients after Third and Fourth Kidney Transplantation

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.

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.

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.

Results on third kidney transplantation showed satisfactory patient and graft survival with acceptable outcome.