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Related Experiment Videos

Cadaver retransplants.

K Ogura, J M Cecka

    Clinical Transplants
    |January 1, 1990
    PubMed
    Summary
    This summary is machine-generated.

    Second kidney transplant survival rates are lower than first transplants, but good early function and longer first graft duration improve outcomes. HLA matching and transfusions benefit acute responders, while positive crossmatches may contraindicate retransplantation.

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    Area of Science:

    • Nephrology
    • Transplantation Immunology
    • Organ Transplantation

    Background:

    • Second kidney transplants generally exhibit lower survival rates compared to first transplants.
    • Factors influencing the success of second kidney transplants require further investigation to optimize patient outcomes.

    Purpose of the Study:

    • To analyze the survival rates of second kidney grafts in comparison to first and third grafts.
    • To identify prognostic factors influencing second kidney transplant success, including early graft function, prior graft duration, and immunological parameters.
    • To evaluate the utility of specific crossmatch tests and HLA matching in predicting second graft survival.

    Main Methods:

    • Retrospective analysis of patient data comparing survival rates of first, second, and third kidney grafts.

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  • Evaluation of the impact of early graft function (1- and 3-month) on 1-year survival.
  • Assessment of the prognostic value of first-graft duration on second-graft survival.
  • Analysis of flow cytometry crossmatch (FCXM) and antihuman immunoglobulin crossmatch test results.
  • Investigation of the association between responder status, HLA matching, and recipient phenotype (HLA-DR1) with graft survival.
  • Comparison of survival rates between transfused and never-transfused recipients.

    • Main Results:

    • Second-graft survival was consistently 10% lower than first grafts (67% at 1 year vs. 77%).
    • Good early graft function (1- and 3-month) in second transplants showed survival rates comparable to first transplants.
    • Longer first-graft duration (>12 months) significantly improved second-graft survival (75% at 1 year).
    • Positive FCXM, especially with short first-graft duration, was associated with poor outcomes (48% 3-month survival) and suggested contraindication for retransplantation.
    • HLA matching significantly benefited acute responders, with 0-HLA-A,B-mismatched grafts showing higher 1-year survival (72%) compared to 4 mismatched grafts (58%).
    • HLA-DR1 positive recipients had a 10-15% increased survival rate.
    • Transfused recipients had better 1-year survival (69%) compared to never-transfused recipients (59%).

    Conclusions:

    • Second kidney transplant outcomes are influenced by early graft function, prior graft survival duration, and immunological factors.
    • FCXM is a valuable screening tool, and a positive result with short prior graft duration may contraindicate retransplantation.
    • HLA matching and pre-transplant transfusions are beneficial, particularly for acute responders, suggesting personalized approaches to optimize retransplant success.