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Updated: Jan 26, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Pilot Experience with ABO-Incompatible Kidney Transplantation as a Second Transplant
Junji Uchida1, Akihiro Kosoku2, Kazuya Kabei2
1Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan, m9492120@msic.med.osaka-cu.ac.jp.
Background:
Despite advances in immunosuppressant medications, improvement in long-term survival for kidney transplant recipients has been more difficult to achieve. In fact, the number of patients with failing grafts who must either return to dialysis or undergo a second transplant is increasing. Second transplantation is associated with reduced mortality rates compared to remaining on dialysis after an initial graft loss. Nowadays, excellent ABO-incompatible kidney transplant outcomes have been achieved. However, there have been no reports on ABO-incompatible kidney transplantation as a second transplant.
Patients And Methods:
Three patients who received their graft from an ABO-incompatible living donor at our institution as a second transplant were enrolled in this study. We focused on immunosuppressive therapy for second ABO-incompatible kidney transplantation, donor-specific antibody status before the second transplant, patient and graft survivals, and complications.
Results:
All 3 patients successfully underwent ABO-incompatible kidney transplantation as a second transplant with a follow-up period of 141, 39, and 24 months. Patient and graft survival rates were 100%.
Conclusions:
ABO-incompatible kidney transplantation may be an acceptable treatment for patients who need a second renal replacement therapy after their initial graft failure.
Insights
Second kidney transplants using ABO-incompatible donors show promising results, offering a viable option for patients with failing initial grafts. This approach achieved 100% patient and graft survival in a small study group.
Area of Science:
- Nephrology
- Transplantation Immunology
Background:
- Long-term survival for kidney transplant recipients remains challenging despite immunosuppression advances.
- Increasing rates of initial graft failure necessitate effective second transplant options.
- Second kidney transplantation offers better survival than dialysis after initial graft loss.
Purpose of the Study:
- To evaluate the feasibility and outcomes of ABO-incompatible kidney transplantation as a second transplant.
- To analyze immunosuppressive strategies and donor-specific antibody status in this patient population.
Main Methods:
- Retrospective analysis of three patients undergoing second ABO-incompatible kidney transplantation with living donors.
- Focus on immunosuppressive regimens, pre-transplant donor-specific antibody levels, and patient/graft survival.
Main Results:
- All three patients successfully received ABO-incompatible second kidney transplants.
- Follow-up periods ranged from 24 to 141 months.
- Achieved 100% patient and graft survival rates.
Conclusions:
- ABO-incompatible kidney transplantation is a potentially acceptable treatment for patients requiring second renal replacement therapy.
- This approach offers a successful alternative to dialysis after initial graft failure.
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