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Related Experiment Videos

Is repeated mismatching at regrafting deleterious?

G Tufveson1, M Bengtsson, C Bergström

  • 1Department of Surgery (Transplantation Unit), University Hospital, Uppsala, Sweden.

Transplant International : Official Journal of the European Society for Organ Transplantation
|January 1, 1992
PubMed
Summary

Kidney retransplantation is feasible even with repeated HLA mismatches if cross-matches are negative. This study found similar graft survival rates, highlighting the importance of negative T- and B-cell cross-matches for successful renal regrafting.

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Area of Science:

  • Nephrology
  • Immunology
  • Transplantation

Background:

  • Renal retransplantation is a complex procedure.
  • Previous studies have focused on minimizing human leukocyte antigen (HLA) mismatches in subsequent kidney grafts.
  • The impact of repeated HLA mismatches and positive B-cell cross-matches on regraft survival requires further investigation.

Purpose of the Study:

  • To evaluate the clinical outcomes of kidney retransplantation in patients receiving grafts with repeated HLA mismatches.
  • To assess the influence of a weakly positive B-cell cross-match on graft survival in regrafted patients.

Main Methods:

  • Retrospective analysis of 92 patients undergoing second or subsequent renal transplantation between January 1985 and June 1990.
  • Graft survival rates were analyzed based on the presence of repeated HLA mismatches and B-cell cross-match results.

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Main Results:

  • Overall 1-year graft survival was 70%.
  • Patients with repeated HLA mismatches (n=29) had a 1-year survival of 66%, while those without (n=63) had 70% survival.
  • A weakly positive B-cell cross-match was associated with poor outcomes, particularly when combined with repeated HLA mismatches (1/5 survival).

Conclusions:

  • Kidney retransplantation with repeated HLA A or B locus mismatches can be successful if T- and B-cell cross-matches are negative.
  • Negative cross-match results are critical for favorable outcomes in renal regrafting, even with HLA incompatibilities.
  • These findings support careful patient selection and cross-match assessment for optimizing renal retransplantation success.