#3370 RETURN TO DIALYSIS AFTER KIDNEY TRANSPLANTATION, A REALITY OF TODAY: DESCRIBING OUR EXPERIENCE

Abstract Background and Aims Longer survival in renal transplantation means an increase the number of patients who return to dialysis after graft loss. There is little literature about management immunosupression(IS) these complications derived from its maintenance withdrawal/reduction. Method We conducted a retrospective study involving cohort returned failure at Doce de Octubre Hospital 2015 2022. analyzed baseline characteristics, IS withdrawal scheme, 27 months following restart dialysis. Results A total 50 were enrolled study: 58% male, 86% hypertensive, 30% diabetic 52% with heart disease. The median age transplant was 41.5 (33.7-53.2). 70% donations brain death, 18% asystole 10% alive. duration 8.5 years (5,14), 96% developed anti-HLA antibodies 40% suffered active rejection. Upon restarting dialysis, all receiving IS: 84% calcineurin inhibitors (CNI) (tacrolimus, cyclosporine), antimetabolites (mycophenolate, azathioprine), mTOR (everolimus). Haemodialysis performed through central venous catheterization 68.6%. time stop 10 (6,19). Between first third month, imTOR [0(0.4)] antimetabolite [1(0.3)] finalized. Discontinuance CNI steroids 2 (1,8) 8 (3,15.7) respectively. As IS, 64% serious infection 12% diagnosticated neoplasms. On other hand, eighteen presented immunological intolerance graft, 100% requiring steroids, 72.2% percutaneous embolization finally 50% require transplantectomy. rate intolerance, transplantectomy higher during year. Patients on haemodialysis (HD) had compared peritoneal (PD) (40.5% vs 23%), attributable early suspension (62% before year), but similar (61.5%PD, 64.8%HD). At (14.5,44.2) follow-up returning remained (30% waiting list for second kidney transplantation), 28% retransplanted, 8% died. Conclusion Most recipients catheter. Withdrawal immunosuppression months, faster antimetabolites, more progressive steroids. Stop year common group it associated intolerance. Finally we want highlight significant percentage embolizations our hospital, that let us avoid 12.2% transplantectomies.