Kidney Retransplant: Not Too Old for a Second Chance

Pardinhas, Clara; Leal, Rita; Figueiredo, Carolina; Rodrigues, Luís; Guedes, Maria; Santos, Lídia; Romãozinho, Catarina; Sá, Helena; Alves, Rui; Figueiredo, Arnaldo

doi:10.1016/j.transproceed.2022.04.013

Cited by 1 publication

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“…Retransplantation was associated with a 68% lower adjusted risk of death compared with dialysis and this benefit was observed in all subgroups examined including diabetic patients, patients older than 60 years-old, and patients with PRA > 80%. [ 3 ] The survival benefit of retransplantation has been addressed in other specific subgroups including patients with previous posttransplant lymphoproliferative disorders [ 24 ], first graft loss due to BK nephropathy [ 25 ], third or fourth kidney retransplant [ 26 ], and older recipients [ 27 , 28 ] and found similar graft and patient survival rates. Even in patients older than 70 years-old, there was a slight survival advantage in retransplantation as opposed to remaining on dialysis after first graft failure [ 29 ].…”

Section: The Benefits Of Retransplantationmentioning

confidence: 99%

Strategies to Overcome HLA Sensitization and Improve Access to Retransplantation after Kidney Graft Loss

Leal

Pardinhas

Martinho

et al. 2022

JCM

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An increasing number of patients waitlisted for kidney transplantation have a previously failed graft. Retransplantation provides a significant improvement in morbidity, mortality, and quality of life when compared to dialysis. However, HLA sensitization is a major barrier to kidney retransplantation and the majority of the highly sensitized patients are waiting for a subsequent kidney transplant. A multidisciplinary team that includes immunogeneticists, transplant nephrologists and surgeons, and adequate allocation policies is fundamental to increase access to a kidney retransplant. A review of Pubmed, ScienceDirect, and the Cochrane Library was performed on the challenges of kidney retransplantation after graft loss, focusing on the HLA barrier and new strategies to overcome sensitization. Conclusion: Technical advances in immunogenetics, new desensitization protocols, and complex allocation programs have emerged in recent years to provide a new hope to kidney recipients with a previously failed graft.

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