Kidney retransplantation in the ipsilateral iliac fossa: A surgical challenge
American Journal of Transplantation , Volume 15 - Issue 11 p. 2947- 2954
The aim of this study is to review the surgical outcome of kidney retransplantation in the ipsilateral iliac fossa in comparison to first kidney transplants. The database was screened for retransplantations between 1995 and 2013. Each study patient was matched with 3 patients with a first kidney transplantation. Just for graft and patient survival analyses, we added an extra control group including all patients receiving a second transplantation in the contralateral iliac fossa. We identified 99 patients who received a retransplantation in the ipsilateral iliac fossa. There was significantly more blood loss and longer operative time in the retransplantation group. The rate of vascular complications and graft nephrectomies within 1 year was significantly higher in the study group. The graft survival rates at 1 year and 3, 5, and 10 years were 76%, 67%, 61%, and 47% in the study group versus 94%, 88%, 77%, and 67% (p-<-0.001) in the first control group versus 91%, 86%, 78%, and 57% (p-=-0.008) in the second control group. Patient survival did not differ significantly between the groups. Kidney retransplantation in ipsilateral iliac fossa is surgically challenging and associated with more vascular complications and graft loss within the first year after transplantation. Whenever feasible, the second renal transplant (first retransplant) should be performed contralateral to the prior failed one. The authors review the challenges of kidney retransplantation in the ipsilateral iliac fossa in this retrospective case-controlled study, demonstrating increased operative time and intra-operative blood loss, more graft nephrectomies within one year, and decreased graft survival.
|American Journal of Transplantation|
|Organisation||Department of Internal Medicine|
Ooms, L.S.S, Roodnat, J.I, Dor, F.J.M.F, Tran, T.C.K, Kimenai, H.J.A.N, IJzermans, J.N.M, & Terkivatan, T. (2015). Kidney retransplantation in the ipsilateral iliac fossa: A surgical challenge. American Journal of Transplantation, 15(11), 2947–2954. doi:10.1111/ajt.13369