Transplant Nephrectomy Improves Survival Following a Failed Renal Allograft

Overview

Journal J Am Soc Nephrol

Specialty Nephrology

Date 2009 Oct 31

PMID 19875809

Citations 35

Authors

Juan Carlos Ayus

Steven G Achinger

Shuko Lee

Mohamed H Sayegh

Alan S Go

Affiliations

Soon will be listed here.

Abstract

There is a growing number of patients returning to dialysis after a failed kidney transplant, and there is increasing evidence of higher mortality among this population. Whether removal of the failed renal allograft affects survival while receiving long-term dialysis is not well understood. We identified all adults who received a kidney transplant and returned to long-term dialysis after renal allograft failure between January 1994 and December 2004 from the US Renal Data System. Among 10,951 transplant recipients who returned to long-term dialysis, 3451 (31.5%) received an allograft nephrectomy during follow-up. Overall, 34.6% of these patients died during follow-up. Receiving an allograft nephrectomy associated with a 32% lower adjusted relative risk for all-cause death (adjusted hazard ratio 0.68; 95% confidence interval 0.63 to 0.74) after adjustment for sociodemographic characteristics, comorbidity burden, donor characteristics, interim clinical conditions associated with receiving allograft nephrectomy, and propensity to receive an allograft nephrectomy. In conclusion, within a large, nationally representative sample of high-risk patients returning to long-term dialysis after failed kidney transplant, receipt of allograft nephrectomy independently associated with improved survival.

Citing Articles

Losing Much More Than a Transplant: A Qualitative Study of Kidney Transplant Recipients' Experiences of Graft Failure.

Slominska A, Kinsella E, El-Wazze S, Gaudio K, Shamseddin M, Bugeja A Kidney Int Rep. 2024; 9(10):2937-2945.

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Continuation of immunosuppression vs. immunosuppression weaning in potential repeat kidney transplant candidates: a care management perspective.

Hickey M, Singh G, Lum E Front Nephrol. 2023; 3:1163581.

PMID: 37746029 PMC: 10513023. DOI: 10.3389/fneph.2023.1163581.

Allograft nephrectomy vs. no nephrectomy for failed renal transplants.

McDonald M Front Nephrol. 2023; 3:1169181.

PMID: 37675360 PMC: 10479781. DOI: 10.3389/fneph.2023.1169181.

Conservative Kidney Management in Kidney Transplant Populations.

Murakami N, Reich A, Pavlakis M, Lakin J Semin Nephrol. 2023; 43(1):151401.

PMID: 37499572 PMC: 10543459. DOI: 10.1016/j.semnephrol.2023.151401.

Challenges in the Management of the Patient with a Failing Kidney Graft: A Narrative Review.

Leal R, Pardinhas C, Martinho A, Sa H, Figueiredo A, Alves R J Clin Med. 2022; 11(20).

PMID: 36294429 PMC: 9605319. DOI: 10.3390/jcm11206108.

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