[Repeated renal transplantation].
From October 1987 to June 1992, 359 renal transplantations were performed, while, over the same period, 25 patients with a follow-up of more than six months underwent repeat renal transplantation: 23 for a second transplant and 2 for a third transplant. The initial disease was glomerular for 17 patients and interstitial for 6 patients. The mean age of the patients at the time of the repeat transplantation was 36.9 years (range: 20 to 53 years). The mean survival after the first transplantation was 3 years and 10 months (range: 1 week to 10 years). The reasons for loss of the first transplant can be classified as follows: acute rejection (n = 5), chronic rejection (n = 14), surgical failure (n = 5) or sepsis (n = 1). 9 patients received conventional immunosuppressant therapy, while 16 patients (64%) received four-drug therapy including cyclosporin. The actuarial one-year survival of the patients and the transplants was 100% and 92%, respectively. The mean serum creatinine was 136.4 +/- 65 mumol/l (range: 59 to 298 mumol/l). Ten patients developed rejection after a mean of 18.6 days (range: 6 to 30 days) and 2 patients suffered from 2 episodes of rejection within 4 months. These results illustrate the low postoperative surgical and immunological complication rate in this group of patients whose long-term results are at least comparable to those of first transplantations in our group.
Chartier-Kastler
E
E
Clinique Urologique, Groupe Hospitalier Pitié-Salpêtrière, Paris.
Saad
H
H
Mouquet
C
C
Rudelle
E
E
Benalia
H
H
Luciani
J
J
Bitker
M O
MO
Chatelain
C
C
D000206:Actuarial Analysis; D000328:Adult; D001803:Blood Transfusion; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D011183:Postoperative Complications; D012086:Reoperation; D015996:Survival Rate; D013997:Time Factors