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Korean J Transplant 2022; 36(3): 173-179

Published online September 30, 2022

https://doi.org/10.4285/kjt.22.0018

© The Korean Society for Transplantation

First and second kidney transplantations from living donors offer comparable outcomes for patients

Namkee Oh1,* , Min Jung Kim2,* , Kyo Won Lee1 , Hyun Cho3 , Sook Young Woo3 , Jinsoo Rhu1 , Seunghwan Lee4 , Jong Man Kim1 , Gyu-Seong Choi1 , Jae Berm Park1 , Jae-Won Joh1

1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Surgery, Seoul Medical Center, Seoul, Korea
3Department of Statistics and Data Center, Samsung Medical Center, Seoul, Korea
4Department of Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea

Correspondence to: Kyo Won Lee
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
Tel: +82-2-3410-1669
Fax: +82-2-3410-6980
E-mail: kw1980.lee@samsung.com
*These authors contributed equally to this work.

Received: April 7, 2022; Revised: May 23, 2022; Accepted: May 24, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Increasingly many patients are being relisted for repeat kidney transplantation due to longer survival times after transplantation. This study compared the outcomes of second living donor kidney transplantations (LDKTs) with those of first LDKTs.
Methods: Data were collected retrospectively for 1,429 LDKTs performed from 1995 to 2020 at Samsung Medical Center. The demographics of recipients and donors, immunologic factors, and outcomes of second LDKTs were compared to those of first LDKTs.
Results: Among 1,429 cases of LDKT, 1,355 were first LDKT cases and 74 were second LDKT cases. Basic demographic data were comparable for the two groups of patients. The 5- and 10-year graft survival rates were 94% and 84% for first LDKTs and 96% and 86% for second LDKTs, respectively, with neither difference statistically significant (P=0.399). The 5- and 10-year patient survival rates were 98% and 94% for the first and 96% and 93% for the second LDKTs, respectively; neither difference was statistically significant (P=0.766). Multivariate analysis confirmed that a history of previous transplantation was not a statistically significant risk factor for graft loss (hazard ratio [HR], 0.83; P=0.677) or patient death (HR, 1.68; P=0.396).
Conclusions: These results indicate that repeat kidney transplantation from living donors is a reasonable choice for patients who have experienced graft loss.

Keywords: Kidney transplantation, Renal transplantation, Living donors, Graft survival

HIGHLIGHTS
  • This single-center, retrospective study compared first and second living donor kidney transplant outcomes.

  • No significant differences in patient or graft survival were found at 5 and 10 years.

  • However, second transplants were found to be more immunologically complex in terms of donor-specific antibodies and received anti-thymocyte globulin more frequently.