Long-term outcome of kidney retransplants with different donor sources

Background It has been reported that the long-term survival of second transplants may be similar to that of primary transplants. Reports of retransplantation outcomes are scarce, especially in the middle east region. We aimed to present our experience with second renal transplant in Kuwait and compare the donor source among our retransplant recipients. Patients and methods Data of kidney retransplants, under follow-up at the Hamed Al-essa Organ Transplant Center of Kuwait, between 1980 and 2019 were retrospectively analyzed. Out of 3038 kidney transplants, 198 (6.51%) were kidney retransplants. The number of kidney transplants from living donors was 150; from deceased donors, 48 and third transplants represented 15 cases. We compared living donor group 1 with deceased donor group 2 in terms of demographics, posttransplant complications and outcome. Results We observed that episodes of acute antibody-mediated rejection (nine cases, 18.7%, in group 1 vs. eight cases, 16.6%, in group 2, respectively) and T-cell-mediated rejection (14 cases, 9.33%, in group 1 vs.15 cases, 10%, in group 2, respectively) were more frequent among patients in group 2, but this did not reach statistical significance. In terms of the second graft outcome, we observed that the percentage of patients with failed grafts was higher among group 2 patients, but this did not reach statistical significance during their last follow-up, while the two groups were comparable in terms of patient outcome. Conclusion Both living donor and cadaveric renal allotransplants carry the same risk for graft rejection, either AMR or ACR. Meanwhile retransplants who received their kidneys from either living or deceased donors had experienced similar graft and patients’ outcomes. Therefore, retransplant either from living or deceased donor is considered a good option after first renal allograft loss.