Olatise Olalekan O, Asaolu Stephen O, Muoka Michael O, Faponle Adegboyega E, Igbokwe Martin C, Anosike Ikechukwu, Onwuasoanya Uzodimma E, Olatise Adaku T, Vasanth Kumar R
Department of Medicine/Nephrology Unit, Zenith Medical and Kidney Centre, Abuja, NGA.
Department of Clinical Research, Zenith Medical and Kidney Centre, Abuja, NGA.
Cureus. 2022 Dec 14;14(12):e32521. doi: 10.7759/cureus.32521. eCollection 2022 Dec.
Patients with end-stage renal disease have limited options in the course of their management. Kidney transplantation (KT) remains the gold standard for the management of renal replacement therapy. There is increasing evidence supporting the viability of third and fourth KTs. Due to the complexities of carrying out a successful third KT and the scarcity of living organ donors, it is not a common procedure in Nigeria's few renal transplant centres. To date, there is no reported case of a successful third KT in Nigeria. Here, we present the first reported case of a third KT carried out in Nigeria on a 44-year-old hypertensive, hepatitis B-infected, non-diabetic male patient. He had the first living donor KT eight years ago, which he lost due to poor immunosuppressive medication adherence. He then had a second living donor, KT, four years ago. Both KTs were from altruistic donors and were performed in the same hospital outside Nigeria. He developed allograft nephropathy after receiving the AstraZeneca COVID-19 vaccine 16 months ago and lost the second graft as a result. He was worked up and transplanted at our centre. Third kidney transplantation can be performed successfully despite the challenges of human leukocyte antigen (HLA) sensitization, antibiotic resistance, and surgical placement of the graft.
终末期肾病患者在治疗过程中的选择有限。肾移植（KT）仍然是肾脏替代治疗的金标准。越来越多的证据支持第三次和第四次肾移植的可行性。由于成功进行第三次肾移植的复杂性以及活体器官供体的稀缺，在尼日利亚为数不多的肾移植中心，这并不是一种常见的手术。迄今为止，尼日利亚尚无成功进行第三次肾移植的报道。在此，我们报告首例在尼日利亚为一名44岁的高血压、感染乙型肝炎、非糖尿病男性患者进行第三次肾移植的病例。他八年前接受了首例活体供体肾移植，因免疫抑制药物依从性差而失去了移植肾。然后，他在四年前接受了第二次活体供体肾移植。两次肾移植均来自利他性供体，且在尼日利亚境外的同一家医院进行。16个月前，他在接种阿斯利康新冠疫苗后出现移植肾肾病，结果失去了第二个移植肾。他在我们中心接受了检查并进行了移植手术。尽管存在人类白细胞抗原（HLA）致敏、抗生素耐药性以及移植肾手术放置等挑战，但第三次肾移植仍可成功进行。
