Fourteen-year survival of a renal graft reused 2 years after initial transplantation: a case report

Goralczyk, Armin D.; Obed, Aiman; Lorf, Thomas

doi:10.1111/j.1432-2277.2009.01031.x

Cited by 8 publications

(6 citation statements)

References 12 publications

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“…Three case reports of kidney reuse are reported in the literature [8–10], without any major issues. Recently, a fourth report regarding the reuse of the kidney allograft was described where the EM lesions of FSGS in the primary recipient disappeared after it was transplanted into another recipient without underlying FSGS [11].…”

Section: Discussionmentioning

confidence: 99%

Reuse of a previously transplanted kidney: does success come with a price?

Kadambi

Chon

Josephson

et al. 2012

Clinical Kidney Journal

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Longer wait times for deceased donor kidney transplant have prompted newer initiatives to expedite the process. Reuse of a previously transplanted kidney might be appropriate in certain circumstances. However, one must also consider the unique issues that may arise after such transplants. We describe our experience in one such case where the donor kidney had lesions of focal and segmental glomerulosclerosis and signs of alloreactivity (positive C4d staining) prior to transplantation and the recipient developed ganciclovir-resistant cytomegalovirus (CMV) infection, which was perhaps transmitted from the donor. Despite the challenges, the allograft function remained stable 5 years after reuse.

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Section: Discussionmentioning

confidence: 99%

Reuse of a previously transplanted kidney: does success come with a price?

Kadambi

Chon

Josephson

et al. 2012

Clinical Kidney Journal

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“…The authors have reviewed the scanty literature available on this subject, and concluded that since most renal transplant recipients die with a functioning graft, re-transplant of the organ, though challenging, is feasible. [7,14].…”

Section: Discussionmentioning

confidence: 99%

Successful Transplant of Two Kidneys Harvested from a Young Brain-Dead Liver Transplant Recipient

et al. 2016

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Efforts to increase the dismal deceased renal transplantation (DRT): live renal transplantation (LRT) ratio in our country have gathered momentum recently, with governmental and non-governmental projects focussing on building public awareness and capacity-building, and appropriate legislation. Worldwide, efforts at increasing the number of organs from the deceased pool have focussed on the use of 'expanded criteria donors', including deceased cardiac donors (DCD). 'Reuse' transplant, where an organ is transplanted after removal from the first recipient, is a rare strategy, used more commonly in liver than in kidney transplantation. Exceptional circumstances, where other organs have been harvested from transplant recipients, are rare. We describe the successful transplants of two renal grafts obtained from a 19-year-old brain-dead liver transplant recipient; this is probably the second case in English-language literature. A 19-year-old male patient with hepatitis E-induced fulminant hepatic failure underwent live-related liver transplantation. On postoperative day 2, cerebral edema set in, and the patient was declared brain-dead. Despite the economical and emotional trauma, the family opted for donation of the well-perfused kidneys. The kidneys were transported in HTK solution (histidine-tryptophan-ketoglutarate) to our centre. Recipient 1 was a 32-year-old woman (B positive) and recipient 2 was a 29-year-old man (also B positive); the kidneys were placed extraperitoneally and anastomosed end-to-side to the external iliac artery and vein. Recipient 2 experienced delayed graft function; however, both are doing well 15 months posttransplant.

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“…The small number of case reports scattered during the last three decades [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] did not catch the attention of the transplant community until analyses were published from the organ transplant agencies on both sides of the Atlantic [33][34][35]. Lowell et al, with data of the United Network for Organ Sharing and The Scientific Transplant Registry, reported findings on forty-eight recipients of previously re-used kidneys transplanted between October 1987 and June 1996 and compared them to those of 68,568 patients receiving native organs during the same period [33].…”

Section: Historical Aspect Of Transplantation Of the Dwgf Kidneysmentioning

confidence: 99%

“…The time of graft function in the first recipient does not portend any relationship with the graft survival of the second recipient. There have been reports of long follow-up after re-transplantation of 4 to 18 years with good re-used graft function (serum creatinine level of 1.3 mg/dL) after a long graft survival of the first transplant lasting 6 to 10 years [18,[20][21][22][23][24][25][26][27]. Conversely, a short graft life of the first recipient does not influence the length of graft survival in the second recipient or makes them at increased risk of graft loss, as in the case of a 36-year-old who died of a cerebrovascular accident two months after a successful transplant [28].…”

Section: Selection Of the Dwgf Kidneysmentioning

confidence: 99%

“…After the procurement of the intra-abdominal organs, with the distal aorta still clamped, the transplanted kidney is continuously perfused with cold perfusate until it is removed. The ipsilateral iliac vessels are dissected from the aortic bifurcation to the inguinal ligament and removed en bloc with the kidney, the ureter, and the periureteral tissue [15,18,25]. A wedge biopsy of the kidney is mandatory, with a frozen section read by a pathologist knowledgeable in renal transplant histology, rarely available in non-academic centers, to assess any prohibitive chronic damage of the kidney prior to its use.…”

Section: Technical Aspect Of the Organ Recovery And Transplantation O...mentioning

confidence: 99%

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The Deceased Transplant Recipients: A Forgotten Source of Organ Donors

Nghiem

2023

Uro

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Background: Organ transplantation is the most successful therapy for end-stage organ disease since it increases the quality of life and life expectancy. For these reasons, over 107,000 patients were on the waitlist in the United States for a transplant in 2022. Unfortunately, only 42,887 transplants were performed, and annually, over 7000 patients on the kidney list die or are too sick to transplant. To solve this severe organ shortage, the use of the deceased transplant recipients with functioning organs, whether transplanted or native, is explored as a new source of organ donors. Methods: To assess the feasibility of this option, first, we will review the rate of kidney transplant recipients dying with functioning grafts (DWGF), their re-use, the organ allocation system, the technical aspects of the organ procurement, and the transplantation of the DWGF kidneys. Then, we will consider the larger group of all deceased transplant recipients as potential donors for all functioning, native, or transplanted organs. Conclusions: (1). All functioning kidney transplants explanted from the deceased transplant recipients have excellent long-term function after re-transplantation. (2). The other functioning organs constitute a large unrecognized pool of transplantable organs. (3). The intensivists and the transplant community should be educated about these new options to improve the organ shortage.

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Fourteen-year survival of a renal graft reused 2 years after initial transplantation: a case report

Cited by 8 publications

References 12 publications

Reuse of a previously transplanted kidney: does success come with a price?

Reuse of a previously transplanted kidney: does success come with a price?

Successful Transplant of Two Kidneys Harvested from a Young Brain-Dead Liver Transplant Recipient

The Deceased Transplant Recipients: A Forgotten Source of Organ Donors

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