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Improved clinical care and effective immunosuppressive strategies have prolonged the life of renal allografts, though not indefinitely.
Increasing number of patients are coming up for re-transplantation.
We report our experience with renal re-transplants at our centre
•A Retrospective analysis of all patients who underwent renal re-transplantation from January 1 2008 to August 31 2022 was carried out.
•All patients were monitored for their graft function at 1 year, 3 rd year and fifth year.
•Number of living donor renal transplants performed from January 2008 to August 2022: 1150
•Number of Renal Re-transplant 74 (6.4%), 73: Second Transplants , 1: Third transplant
There were 1150 renal transplantation done in our institution form January 2008 to august 2022 of which 74 were renal retransplantaion. Mean age of distribution was 44.8 + 9.5 years , minimum age was 28 and maximum was 67 , majority were in the age group 41 to 60 years.50 (67.6) patients were males and 24(32.4%) patients were females.Male: female ratio was 2:1. Out of 74 patient, 68 (92%)grafts survived after 5 years . 4 (7%)grafts failed in the immediate post operative period. 1 (1.35%)graft failed after 3years due to BKV infection . 1(1.35%) patient died in the immediate post operative period due to post operative complications. Induction was ATG in 27(36%) patients , Graflon in 1(1.35%) patient and basiliximab in 46 (62%)patients. Maintenance immunosuppression was standard in 71 patients (95%)and cyclosporine ,MMF and steroids in 3 patients(4%) . 1(1.35%) patient developed CMV disease and 3(4%) patient had BKV infection. 73(98.64%) patients had desensitization with plasmapheresis and IVIG , 1(1.35%) had no desensitization in whom previous graft failure was due to RVT and underwent immediate graft nephrectomy. •Number of patients who received first renal transplants during the study period 1150-74= 1076 • Out of these, 500 age matched controls were chosen to compare with the retransplant patients.
In our study, patients who received renal re-transplants had similar graft survival, rejection rates and patient survival as compared to those received their first renal transplants.
Due to higher sensitized status, close monitoring of graft function is essential.
Since outcomes are comparable, patients with transplant failure can be offered the option of re-transplantation .