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NDT Advance Access originally published online on October 13, 2008
Nephrology Dialysis Transplantation 2009 24(2):639-642; doi:10.1093/ndt/gfn567
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Does nephrectomy of failed allograft influence graft survival after re-transplantation?

Nadeem Ahmad1, Kamran Ahmed2 and Nizam Mamode1

1 Department of Transplantation, Guy's Hospital 2 Department of Biosurgery and Surgical Technology, Imperial College, St Mary's Hospital, London, UK

Correspondence and offprint requests to: Kamran Ahmed, Department of Biosurgery and Surgical Technology, 10th Floor QEQM Building, St Mary's Hospital, Imperial College, London, UK. Tel: +44-7939319670; Fax: +44-71888767; E-mail: kahmed198{at}yahoo.co.uk



  Abstract

Background. The aim of the study was to determine the effect of removal of a failed kidney allograft on the outcome of subsequent transplant.

Methods. Retrospective analytical study comparing graft survival for patients (1993–2005) who had previous graft nephrectomy with those who had not.

Results. Of 89 patients with kidney re-transplants, 68 had had a transplant nephrectomy (Group I) while 21 had retained failed grafts (Group II). There was no significant difference in the two groups in the PRA level at the time of re-transplantation (37% versus 29%). Mean follow-up was 47 months. Acute rejections in Group I were 49.1% and in Group II, 31.2% (P = 0.20). Twenty (29%) grafts failed in Group I and four (19%) in Group II. One, three and five years’ actuarial graft survival in Group I was 83.8%, 76% and 66.2%, while in Group II, it was 94.7%, 86.8% and 69.5%, respectively (P = 0.66). Five-year actuarial patient survival in Groups I and II was 94.1% and 87.5%, respectively (P = 0.69). Multivariate analysis showed that PRA level significantly influenced graft survival independent of nephrectomy (P = 0.04).

Conclusion. Nephrectomy of a failed allograft does not seem to significantly influence the survival of a subsequent graft.

Keywords: graft nephrectomy; kidney transplant; nephrectomy; renal re-transplantation

Received for publication: 5.12.07
Accepted in revised form: 17. 9.08


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