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Cadaveric kidney retransplantation, is it justified?
Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association
|January 1, 1979
Summary
Second kidney transplants show similar patient survival but varied graft survival based on first graft failure type. Non-immunological failure predicts better outcomes for a second kidney transplant.
Area of Science:
- Nephrology
- Transplantation immunology
Background:
- Kidney transplantation is a vital treatment for end-stage renal disease.
- Second kidney transplants are performed when the primary graft fails.
Purpose of the Study:
- To compare outcomes of second cadaveric kidney transplants with primary transplants.
- To evaluate factors influencing second graft survival after first graft failure.
Main Methods:
- Retrospective analysis of 44 second cadaveric kidney transplantations.
- Comparison with 149 primary cadaveric transplantations.
- Analysis of graft survival based on the cause of first graft failure (immunological vs. non-immunological).
Main Results:
- No significant difference in patient survival between primary and second transplant recipients.
- Two-year second graft survival was significantly higher for patients with non-immunological first graft failure (60%) compared to immunological first graft failure (20%).
- Higher presensitization did not explain the poorer outcomes in the immunological failure group.
Conclusions:
- While patient survival is unaffected, the cause of first kidney graft failure significantly impacts second graft survival.
- Retransplantation with cadaveric kidneys may be questionable for patients with immunological first graft failure due to poor outcomes.