Impact of failed allograft nephrectomy on initial function and graft survival after kidney retransplantation. 2011

Christina Schleicher, and Heiner Wolters, and Linus Kebschull, and Christoph Anthoni, and Barbara Suwelack, and Norbert Senninger, and Daniel Palmes, and Bernadette Mersfeld
Department of General and Visceral Surgery, University of Muenster, Germany. christina.schleicher@ukmuenster.de

The management of an asymptomatic failed renal graft remains controversial. The aim of our study was to explore the effect of failed allograft nephrectomy on kidney retransplantation by comparing the outcome of recipients who underwent graft nephrectomy prior to retransplantation with those who did not. Retrospective comparison of patients undergoing kidney retransplantation with (group A, n = 121) and without (group B, n = 45) preliminary nephrectomy was performed, including subgroup analysis with reference to patients with multiple (≥2) retransplantations and patients of the European Senior Program (ESP). Nephrectomy leads to increased panel reactive antibody (PRA) levels prior to retransplantation and is associated with significantly increased rates of primary nonfunction (PNF; P = 0.05) and acute rejection (P = 0.04). Overall graft survival after retransplantation was significantly worse in group A compared with group B (P = 0.03). Among the subgroups especially ESP patients showed a shorter graft survival after previous allograft nephrectomy. On the multivariate analysis, pretransplant graft nephrectomy and PRA >70% were independent and significant risk factors associated with graft loss after kidney retransplantation. Nephrectomy of the failed allograft was not beneficial for retransplant outcome in our series. Patients with failed graft nephrectomy tended to have a higher risk of PNF and acute rejection after retransplantation. The possibility that the graft nephrectomy has a negative impact on graft function and survival after retransplantation is worth studying further.

UI MeSH Term Description Entries
D007668 Kidney Body organ that filters blood for the secretion of URINE and that regulates ion concentrations. Kidneys
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009392 Nephrectomy Excision of kidney. Heminephrectomy,Heminephrectomies,Nephrectomies
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D005260 Female Females
D006084 Graft Rejection An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. Transplant Rejection,Rejection, Transplant,Transplantation Rejection,Graft Rejections,Rejection, Graft,Rejection, Transplantation,Rejections, Graft,Rejections, Transplant,Rejections, Transplantation,Transplant Rejections,Transplantation Rejections
D006085 Graft Survival The survival of a graft in a host, the factors responsible for the survival and the changes occurring within the graft during growth in the host. Graft Survivals,Survival, Graft,Survivals, Graft
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

Related Publications

Christina Schleicher, and Heiner Wolters, and Linus Kebschull, and Christoph Anthoni, and Barbara Suwelack, and Norbert Senninger, and Daniel Palmes, and Bernadette Mersfeld
September 2005, Transplantation proceedings,
Christina Schleicher, and Heiner Wolters, and Linus Kebschull, and Christoph Anthoni, and Barbara Suwelack, and Norbert Senninger, and Daniel Palmes, and Bernadette Mersfeld
February 2009, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association,
Christina Schleicher, and Heiner Wolters, and Linus Kebschull, and Christoph Anthoni, and Barbara Suwelack, and Norbert Senninger, and Daniel Palmes, and Bernadette Mersfeld
April 2018, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association,
Christina Schleicher, and Heiner Wolters, and Linus Kebschull, and Christoph Anthoni, and Barbara Suwelack, and Norbert Senninger, and Daniel Palmes, and Bernadette Mersfeld
October 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation,
Christina Schleicher, and Heiner Wolters, and Linus Kebschull, and Christoph Anthoni, and Barbara Suwelack, and Norbert Senninger, and Daniel Palmes, and Bernadette Mersfeld
February 2013, International urology and nephrology,
Christina Schleicher, and Heiner Wolters, and Linus Kebschull, and Christoph Anthoni, and Barbara Suwelack, and Norbert Senninger, and Daniel Palmes, and Bernadette Mersfeld
January 2014, Transplantation proceedings,
Christina Schleicher, and Heiner Wolters, and Linus Kebschull, and Christoph Anthoni, and Barbara Suwelack, and Norbert Senninger, and Daniel Palmes, and Bernadette Mersfeld
January 2019, Transplantation reviews (Orlando, Fla.),
Christina Schleicher, and Heiner Wolters, and Linus Kebschull, and Christoph Anthoni, and Barbara Suwelack, and Norbert Senninger, and Daniel Palmes, and Bernadette Mersfeld
May 2011, Archivos espanoles de urologia,
Christina Schleicher, and Heiner Wolters, and Linus Kebschull, and Christoph Anthoni, and Barbara Suwelack, and Norbert Senninger, and Daniel Palmes, and Bernadette Mersfeld
December 1997, Clinical transplantation,
Christina Schleicher, and Heiner Wolters, and Linus Kebschull, and Christoph Anthoni, and Barbara Suwelack, and Norbert Senninger, and Daniel Palmes, and Bernadette Mersfeld
January 2022, Journal of transplantation,
Copied contents to your clipboard!