Intermediate-term outcome of renal retransplants in the cyclosporine era.
To determine the influence of selected parameters on intermediate-term outcome of renal retransplants, univariate and multiple regression analyses were performed on all 100 consecutive cyclosporine treated retransplants performed between 1984 and 1990 (mean follow up, 4.6 +/- 2.3 years). Actual 1 year and actuarial 5 year graft survivals were higher in living compared with cadaver donor transplants (84% and 79% vs 69% and 56%, respectively; p < 0.05). Among cadaver donor transplant recipients, allografts with immediate early function had better 1 and 5 year graft survivals when compared with those with delayed function (81% and 62% vs 59% and 38%, respectively; p < 0.05). Recipients with acute rejection had inferior 1 year and 5 year graft survivals when compared with rejection free patients (65% and 35% vs 80% and 57%, respectively; p < 0.05). Graft survival time of primary transplants was also a significant predictor of retransplant outcome with 1 and 5 year graft survivals of 50% and 36%, respectively, in patients in whom primary grafts survived less than 3 months, compared with 75% and 58% in those in whom grafts survived longer than 3 months (p < 0.05). Recipient age, race, renal disease, and levels of panel reactive antibodies had no effect on intermediate-term outcome. In a multiple regression analysis, delayed graft function, acute rejection, and primary graft survival time less than 3 months correlated inversely with long-term survival of retransplants (multiple r = 0.65). A total of 39 grafts were lost due to rejection (22), sepsis (6), graft nonfunction (5), death with a functioning graft (4), noncompliance (1), and recurrent renal disease (1).(ABSTRACT TRUNCATED AT 250 WORDS)
Sumrani
N B
NB
Department of Medicine, State University of New York Health Science Center, Brooklyn 11203.
Miles
A M
AM
Daskalakis
P
P
Hong
J H
JH
Markell
M S
MS
Friedman
E A
EA
Sommer
B G
BG
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007165:Immunosuppression Therapy; D007674:Kidney Diseases / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012086:Reoperation; D012189:Retrospective Studies; D012959:Socioeconomic Factors
D016572:Cyclosporine