Factors influencing the outcome of sequential renal transplants

Of 181 kidney transplantations performed on 151 patients in our center during the years 1971-82, 34 were retransplantations performed on 26 patients with follow-up periods ranging from 1 month to 10 years. One-year actuarial patient survival was 77.2% (82 of 122) for first cadaveric-graft recipients, 95.8% (21 of 26) for second- and 100% (6 of 6) for third-graft recipients. One-year actuarial graft survival was 44.5% (52 of 122) for first cadaveric grafts, 40.8% (10 of 26) for second grafts and 67% (4 of 6) for third grafts. Age, sex and blood group of the recipients did not seem to influence second-graft survival, nor did cumulative duration of hemodialysis and cold ischemic time. A beneficial influence, although not statistically significant, was noted by a longer first-graft survival time, better HLA matching and shorter total warm ischemic time. Retransplantation within 2 months after loss of the first graft and/or the absence of cytotoxic antibodies was found to have a statistically significant beneficial influence.