Beyond the Limits: How to Avoid a Surgical Nightmare in the Third and Subsequent Renal Transplantation Procedures.
PURPOSE OF REVIEW
Approximately, 25% of the patients with ESRD will enter the waiting list for kidney transplantation. Among these patients, almost 15% will require a retransplantation surgery. This review aims to summarize the most recent information on different controversial issues regarding retransplantation, to provide the reader with a clear and updated view on the topic.


RECENT FINDINGS
Despite current evidence is mainly based on retrospective, small, single-center experiences, it seems clear that retransplantation remains a surgical and immunological challenge, for which the perioperative management still remains crucial to avoid mishaps. Different surgical approaches have been tested, but the general consensus advocates for the heterotopic extraperitoneal in first instance. Although higher immunological risk and complication rates are reported invariably in the available series, the benefits in terms of overall survival are superior to those obtained under dialysis, thus still representing the most recommended option for this group of patients.
['Lledó-García|Enrique|E|', 'González|Javier|J|', 'Martínez-Holguín|Elena|E|', 'Herranz-Amo|Felipe|F|', 'Hernández-Fernández|Carlos|C|']
D006801:Humans D007676:Kidney Failure, Chronic D016030:Kidney Transplantation D011183:Postoperative Complications D012086:Reoperation D012189:Retrospective Studies
Kidney transplantation Retransplantation Complication rate Immune rejection Vascular thrombosis