A Single-Center Retrospective Study of Re-Transplantation After Allograft Failure in Kidney Transplant Recipients

Background. This study aimed to examine the outcomes of kidney retransplantation in patients with allograft failure at Kyushu University. Methods. We reviewed data from 1043 consecutive patients (including 1001 in a fi rst kidney transplantation [KT] group and 42 in a second KT group) who had undergone KT alone at our institution between January 2008 and September 2022. We also studied immunologic risks and outcomes of patients who had undergone preoperative testing for KT at Kyushu University during the same period. Results. No patient received more than 2 transplants. Donor -speci fi c anti-HLA antibody (DSA) had been detected in a greater percentage of patients in the second KT group than in the fi rst (31% vs 11%, respectively; P < .001). There were no signi fi cant differences in 5 -year deathcensored/overall graft survival rates, rates of surgical complications, or incidence of delayed graft function between the groups. During the study period, signi fi cantly more candidates for second than fi rst KT were rejected for this procedure because of their high immunologic risk (20% vs 2%, P < 001). Seven of the 42 patients in the second KT group required the removal of the primary graft during the second transplantation. Conclusion. There is a higher percentage of patients whose DSA has been detected among patients undergoing retransplantation after allograft failure than among those receiving fi rst KTs, which often leads to remaining on the waiting list in the former group. However, if the immunologic risk is within acceptable limits, the graft survival for retransplantation is not inferior to that of a fi rst KT.