RESUMO
BACKGROUND: Procurement and retransplantation of a previously transplanted kidney reclaim a functioning organ that would otherwise have been discarded. METHODS: Case series of 3 retransplantation cases within the course of 1 calendar year. RESULTS: These cases illustrate how to overcome the immunological, logistical, and technical barriers that have thus far limited the potential of this approach. Within this series, we report kidney reuse weeks and years after the original transplantation, as well as the previously undescribed "living donation of a deceased donor kidney". CONCLUSIONS: Retransplantation of previously transplanted kidneys can be performed successfully and should be considered in the face of the current organ shortage.
Assuntos
Seleção do Doador , Transplante de Rim/métodos , Doadores de Tecidos/provisão & distribuição , Adolescente , Adulto , Evolução Fatal , Feminino , Sobrevivência de Enxerto , Histocompatibilidade , Humanos , Transplante de Rim/efeitos adversos , Doadores Vivos/provisão & distribuição , Masculino , Pessoa de Meia-Idade , Reoperação , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
The disparity between kidney transplant candidates and donors necessitates innovations to increase organ availability. Transporting kidneys allows for living donors and recipients to undergo surgery with a familiar transplant team, city, friends, and family. The effect of shipping kidneys and prolonged cold ischemia time (CIT) with living donor transplantation outcomes is not clearly known. This retrospective matched (age, gender, race, and year of procedure) cohort study compared allograft outcomes for shipped live donor kidney transplants and nonshipped living donor kidney transplants. Fifty-seven shipped live donor kidneys were transplanted from 31 institutions in 26 cities. The mean shipping distance was 1634 miles (range 123-2811) with mean CIT of 12.1 ± 2.8 h. The incidence of delayed graft function in the shipped cohort was 1.8% (1/57) compared to 0% (0/57) in the nonshipped cohort. The 1-year allograft survival was 98% in both cohorts. There were no significant differences between the mean serum creatinine values or the rates of serum creatinine decline in the immediate postoperative period even after adjusted for gender and differences in recipient and donor BMI. Despite prolonged CITs, outcomes for shipped live donor kidney transplants were similar when compared to matched nonshipped living donor kidney transplants.
