Impact of Renal Graft Nephrectomy on Second Kidney Transplant Survival

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2013 Jan 19

PMID 23328966

Citations 4

Authors

Nicolas Surga

Ludovic Viart

Morgane Wetzstein

Hakim Mazouz

Sylvie Collon

Xavier Tillou

Affiliations

Soon will be listed here.

Abstract

Purpose: To determine the impact of non-functional renal graft nephrectomy on second kidney transplantation survival.

Methods: We performed a retrospective study on patients managed in our department from April 1989 to April 2011. We compared the number of acute graft rejections and graft survival between patients undergoing second transplantation with (Group I) or without (Group II) prior graft nephrectomy.

Results: A total of ninety-one patients received a second renal graft: 43 underwent graft nephrectomy and 48 kept their non-functional renal graft. There were 5 episodes of acute graft rejection in Group I and 12 in Group II (p = 0.3). Six (13.9 %) grafts failed in Group I and eight (16.6 %) in Group II. Five and 10 years actuarial graft survival in Group I were, respectively, 91 and 85 %, while in Group II were 82.7 % and 69 % (p = 0.2). PRA level and number of acute rejection episodes did not have a statistically significant influence on graft survival, whether the patient had a nephrectomy or not (p = 0.2).

Conclusion: Nephrectomy of a failed allograft did not significantly improve the survival of a subsequent graft. Graft nephrectomy should be indicated in case of graft-related pain or a chronic inflammation syndrome.

Citing Articles

Management of patients with a failed kidney transplant: what should we do?.

Fiorentino M, Gallo P, Giliberti M, Colucci V, Schena A, Stallone G Clin Kidney J. 2021; 14(1):98-106.

PMID: 33564409 PMC: 7857798. DOI: 10.1093/ckj/sfaa094.

Chronic dialysis in patients with end-stage renal disease: Relevance to kidney xenotransplantation.

Jagdale A, Cooper D, Iwase H, Gaston R Xenotransplantation. 2018; 26(2):e12471.

PMID: 30456901 PMC: 6476633. DOI: 10.1111/xen.12471.

Management of patients with a failed kidney transplant: Dialysis reinitiation, immunosuppression weaning, and transplantectomy.

Pham P, Everly M, Faravardeh A, Pham P World J Nephrol. 2015; 4(2):148-59.

PMID: 25949929 PMC: 4419125. DOI: 10.5527/wjn.v4.i2.148.

Impact of transplant nephrectomy on peak PRA levels and outcome after kidney re-transplantation.

Tittelbach-Helmrich D, Pisarski P, Offermann G, Geyer M, Thomusch O, Hopt U World J Transplant. 2014; 4(2):141-7.

PMID: 25032103 PMC: 4094949. DOI: 10.5500/wjt.v4.i2.141.

References

Ahmad N, Ahmed K, Mamode N . Does nephrectomy of failed allograft influence graft survival after re-transplantation?. Nephrol Dial Transplant. 2008; 24(2):639-42. DOI: 10.1093/ndt/gfn567. View

Atar E, Belenky A, Yussim A, Bar-Nathan N, Bachar G . Nonfunctioning renal allograft embolization as an alternative to graft nephrectomy: report on seven years' experience. Cardiovasc Intervent Radiol. 2002; 26(1):37-9. DOI: 10.1007/s00270-002-1976-z. View

Abouljoud M, Deierhoi M, Hudson S, Diethelm A . Risk factors affecting second renal transplant outcome, with special reference to primary allograft nephrectomy. Transplantation. 1995; 60(2):138-44. View

Lopez-Gomez J, Perez-Flores I, Jofre R, Carretero D, Rodriguez-Benitez P, Villaverde M . Presence of a failed kidney transplant in patients who are on hemodialysis is associated with chronic inflammatory state and erythropoietin resistance. J Am Soc Nephrol. 2004; 15(9):2494-501. DOI: 10.1097/01.ASN.0000137879.97445.6E. View

Lorenzo V, Diaz F, Perez L, Dominguez M, Machado M, Rodriguez A . Ablation of irreversibly rejected renal allograft by embolization with absolute ethanol: a new clinical application. Am J Kidney Dis. 1993; 22(4):592-5. DOI: 10.1016/s0272-6386(12)80934-6. View

Sumrani N, Delaney V, Hong J, Daskalakis P, Sommer B . The influence of nephrectomy of the primary allograft on retransplant graft outcome in the cyclosporine era. Transplantation. 1992; 53(1):52-5. DOI: 10.1097/00007890-199201000-00009. View

Barocci S, Valente U, Nocera A . Detection and analysis of HLA class I and class II specific alloantibodies in the sera of dialysis recipients waiting for a renal retransplantation. Clin Transplant. 2007; 21(1):47-56. DOI: 10.1111/j.1399-0012.2006.00578.x. View

Vanrenterghem Y, Khamis S . The management of the failed renal allograft. Nephrol Dial Transplant. 1996; 11(6):955-7. View

Khakhar A, Shahinian V, House A, Muirhead N, Hollomby D, Leckie S . The impact of allograft nephrectomy on percent panel reactive antibody and clinical outcome. Transplant Proc. 2003; 35(2):862-3. DOI: 10.1016/s0041-1345(02)04031-9. View

10.

Lair D, Coupel S, Giral M, Hourmant M, Karam G, Usal C . The effect of a first kidney transplant on a subsequent transplant outcome: an experimental and clinical study. Kidney Int. 2005; 67(6):2368-75. DOI: 10.1111/j.1523-1755.2005.00343.x. View

11.

Hardy S, Lee S, Terasaki P . Sensitization 2001. Clin Transpl. 2002; :271-8. View

12.

Douzdjian V, Rice J, Carson R, Gugliuzza K, Fish J . Renal retransplants: effect of primary allograft nephrectomy on early function, acute rejection and outcome. Clin Transplant. 1996; 10(2):203-8. View

13.

Ayus J, Achinger S, Lee S, Sayegh M, Go A . Transplant nephrectomy improves survival following a failed renal allograft. J Am Soc Nephrol. 2009; 21(2):374-80. PMC: 2834539. DOI: 10.1681/ASN.2009050480. View

14.

Perez Martinez J, Gallego E, Julia E, Llamas F, Lopez A, Palao F . [Embolization of non-functioning renal allograft: efficacy and control of systemic inflammation]. Nefrologia. 2005; 25(4):422-7. View

15.

Yagmurdur M, Emiroglu R, Ayvaz I, Sozen H, Karakayali H, Haberal M . The effect of graft nephrectomy on long-term graft function and survival in kidney retransplantation. Transplant Proc. 2005; 37(7):2957-61. DOI: 10.1016/j.transproceed.2005.07.022. View

16.

Johnston O, Rose C, Landsberg D, Gourlay W, Gill J . Nephrectomy after transplant failure: current practice and outcomes. Am J Transplant. 2007; 7(8):1961-7. DOI: 10.1111/j.1600-6143.2007.01884.x. View

17.

Bennett W . The failed renal transplant: in or out?. Semin Dial. 2005; 18(3):188-9. DOI: 10.1111/j.1525-139X.2005.18306.x. View

18.

Schleicher C, Wolters H, Kebschull L, Anthoni C, Suwelack B, Senninger N . Impact of failed allograft nephrectomy on initial function and graft survival after kidney retransplantation. Transpl Int. 2010; 24(3):284-91. DOI: 10.1111/j.1432-2277.2010.01197.x. View

19.

Zargar M, Kamali K . Reasons for transplant nephrectomy: a retrospective study of 60 cases. Transplant Proc. 2001; 33(5):2655-6. DOI: 10.1016/s0041-1345(01)02134-0. View

20.

Kmetec A, Kaplan-Pavlovcic S, Ferluga D . Renal cell carcinoma in nonfunctioning transplanted kidney. Am J Nephrol. 2001; 21(3):256-8. DOI: 10.1159/000046258. View