The Effect of Graft Nephrectomy on Long-Term Graft Function and Survival in Kidney Retransplantation

Yağmurdur, Mahmut Can; Emiroğlu, R; Ayvaz, I.; Sozen, Hakan; Karakayalı, H.; Haberal, Mehmet

doi:10.1016/j.transproceed.2005.07.022

Cited by 31 publications

(21 citation statements)

References 13 publications

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“…Universally reported KRT graft survival has been lower than primary transplant, but re-transplantation is still advantageous over maintenance hemodialysis or peritoneal dialysis in terms of improved patient survival, better quality of life, and cost effectiveness (5)(6)(7)9,10,(31)(32)(33)(34)(35). This study showed that the short and intermediate graft survival rates of repeat kidney transplantation were not significantly different between the two groups.…”

Section: Discussionmentioning

confidence: 59%

Early Steroid Withdrawal in Repeat Kidney Transplantation

Mujtaba¹,

Taber²,

Goggins³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Kidney re-transplantation (KRT) candidates are considered at high risk for graft failure. Most of these patients are kept on a chronic steroid maintenance (CSM) regimen. The safety of early steroid withdrawal (ESW) remains unanswered in KRT.Design, setting, participants, & measurements This study was aimed at comparing the outcomes of ESW and CSM in KRT. Retrospective analysis of 113 KRT patients (ESW, n ϭ 59; CSM, n ϭ 54) was performed. All patients received rabbit anti-thymocyte globulin/steroid induction and were maintained on mycophenolate/tacrolimus (Ϯsteroids).Results One-and 5-year patient survival for the ESW and the CSM group were not significantly different (98 versus 96% and 91 versus 88%, respectively; P ϭ 0.991). No significant difference was seen in the graft survival for both groups at 1 and 5 years (98 versus 93% and 80 versus 74%, respectively; P ϭ 0.779). Mean 1-and 5-year estimated GFR was not statistically different between the groups (P ϭ 0.773 and 0.790, respectively). The incidence of acute rejection at 1 year was 17 and 22% in ESW and CSM patients, respectively (P ϭ 0.635). Compared with the ESW group, patients in the CSM group were more likely to be hyperlipidemic (P ϭ 0.044), osteoporotic (P ϭ 0.010), post-transplant diabetics (P ϭ 0.051) and required more medications to control BP (P ϭ 0.004).Conclusions ESW seems to be a reasonable approach in KRT recipients because the short and intermediate patient survival, graft survival, and graft function is comparable to CSM immunosuppression.

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Section: Discussionmentioning

confidence: 59%

Early Steroid Withdrawal in Repeat Kidney Transplantation

Mujtaba¹,

Taber²,

Goggins³

et al. 2011

Clinical Journal of the American Society of Nephrology

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“…The high success rates of primary kidney transplants and longer graft life due to better immunosuppression have led to a larger number of transplant patients living longer and inevitably a larger patient population with failed primary kidney transplants [1,2]. The same level of successful outcomes has not been achieved for patients who are retransplanted in terms of lifespan of the second allograft [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…The same level of successful outcomes has not been achieved for patients who are retransplanted in terms of lifespan of the second allograft [2,3]. There has been little research looking at retransplantation in patients with a failed primary kidney transplant and how to achieve the best outcome.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Graft Nephrectomy on Subsequent Transplants: Multivariate Analysis of Risk Factors for Second Graft Loss and for Multiple Transplantations–A Single-Center Retrospective Study

Giorgakis

Syed

González

2013

ISRN Transplantation

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Retrospective Study" [1] has been retracted. The data reported in the article were not reviewed by the Renal Transplant Unit of the Royal London Hospital before submission. The data is not a complete capture and as a result is not an accurate reflection of the effect of the intervention. Introduction. The management of a failed primary allograft remains unclear and the evidence of the effect of transplantectomy to future transplants conflicting. Aim of this study is to review the impact of failed primary graft nephrectomy on future transplants. Materials/Methods. Retrospective study of 101 patients retransplanted in a single institution. Median follow-up was 68 months. Patients were divided into two groups; G1 ( = 49) was the nephrectomy group; G2 ( = 52) was the graft in situ group. The patients' and second graft survival were analysed with the Kaplan-Meier method. The patients' and transplant characteristics were analyzed with student's -test. The retransplant risk factors and the risk factors for multiple transplants were obtained via a logistic regression model. Results. The odds of second graft loss post-transplantectomy were high (OR = 5.24). Demographics, HLA mismatch and first graft rejection rates were similar among the two groups and did not affect the outcome. Transplantectomy accelerated the loss of a future failing graft. Multivariate analysis showed transplantectomy as independent risk factor for second allograft loss. Transplantectomy and younger age are significant independent risk factors for future multiple transplants. Conclusion. Transplantectomy of the failed primary graft is an independent risk factor for retransplant loss and for multiple renal transplants. References

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“…The role of transplant nephrectomy in the management of transplant failure patients has only been examined in small single center studies (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Some investigators have advocated against the removal of the asymptomatic failed allograft due to the morbidity and mortality associated with transplant nephrectomy (9,12).…”

Section: Introductionmentioning

confidence: 99%