Single-center experience with third and fourth kidney transplants

Katrin Kienzl-Wagner, Walter Mark, Manuel Maglione, Gerald Brandacher, Robert Ãllinger, Raimund Margreiter, Johann Pratschke, Claudia Bösmüller

Research output: Contribution to journalArticle


Kidney retransplantation is often associated with a higher immunological risk than is primary renal transplantation. Faced with increasing organ shortage and growing waiting lists, results of kidney retransplantation are of particular interest. Fifty-six third and fourth kidney transplants were analyzed retrospectively. Parameters included patient and donor demographics, operative details, incidence of surgical, immunological and infectious complications and patient and graft survival. Patients receiving third kidney grafts had 1- and 5-year patient/graft survival rates of 97.4%/72.9% and 88.9%/53.6%, respectively. Episodes of acute rejection and delayed graft function were observed in 44% and 49% of these patients. Fourth kidney transplantation was associated with 1- and 2-year patient/graft survival rates of 84.8%/68.5% and 63.6%/47%, respectively. Acute rejection and delayed graft function occurred in 33% and in 60% of cases. Acceptable patient and graft survival may be achieved after third and fourth kidney transplantation. Graft losses in this sensitized population are mainly because of rejection. Profound immunosuppression may lead to major infectious problems.

Original languageEnglish (US)
Pages (from-to)780-786
Number of pages7
JournalTransplant International
Issue number8
StatePublished - Aug 1 2011
Externally publishedYes


  • fourth transplant
  • kidney retransplantation
  • kidney transplantation
  • third transplant

ASJC Scopus subject areas

  • Transplantation

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