title: Pre-Emptive Retransplantation in Patients With Chronic Kidney Graft Failure.
abstract: BACKGROUND
  The aim of this study was to compare the group of patients receiving a new kidney transplant before starting dialysis again (pre-reTR) with a group of patients receiving a new kidney transplant after restarting dialysis (reTR).
  
  
  METHODS
  This retrospective cohort included all the kidney retransplantations (second transplantations) between 2000 and 2012 performed at our center and their follow-up until July 2014. We analysed graft and patient survival, rejection rates, and immunologic parameters of these patients.
  
  
  RESULTS
  We studied 18 patients who had pre-reTR and 83 who had reTR. In the pre-reTR group no patient had panel-reactive assay (PRA) >10% at any time. In the reTR group 26.5% had PRA >10% at the time of transplantation (P = .014) and 54.2% had a historical highest PRA >10% (P < .001). The rejection rate was 11.1% in the pre-reTR group and 27.7% in the reTR group during the first year post-retransplantation (P = .227). Patient survival rate was 100% in the pre-reTR group at 5 years of follow-up, whereas in the reTR group at 1 year it was 95.2% and 85.9% at 5 years after retransplantation. Allograft survival at 1 and 5 years was 88% and 89%, respectively, in the pre-reTR group. On the other hand, in the reTR group it was 89% after the first year and 65% at 5 years post-retransplantation.
  
  
  CONCLUSIONS
  Pre-emptive renal retransplantation is a feasible option that should be assessed in patients with kidney graft failure and may help to minimize the morbidity associated with dialysis reinitiation.
authors.affiliation: Servicio de Nefrología - Clinical Institute of Nephrology and Urology, Hospital Clinic, Barcelona, Spain.
authors.forename: E A
authors.initials: EA
authors.lastname: Florit
authors.affiliation: Servicio de Nefrología - Clinical Institute of Nephrology and Urology, Hospital Clinic, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Bennis
authors.affiliation: Servicio de Nefrología - Clinical Institute of Nephrology and Urology, Hospital Clinic, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Rodriguez
authors.affiliation: Servicio de Nefrología - Clinical Institute of Nephrology and Urology, Hospital Clinic, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Revuelta
authors.affiliation: Servicio de Nefrología - Clinical Institute of Nephrology and Urology, Hospital Clinic, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: De Sousa
authors.affiliation: Servicio de Nefrología - Clinical Institute of Nephrology and Urology, Hospital Clinic, Barcelona, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Esforzado
authors.affiliation: Servicio de Nefrología - Clinical Institute of Nephrology and Urology, Hospital Clinic, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Cofán
authors.affiliation: Servicio de Nefrología - Clinical Institute of Nephrology and Urology, Hospital Clinic, Barcelona, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Ricart
authors.affiliation: Servicio de Nefrología - Clinical Institute of Nephrology and Urology, Hospital Clinic, Barcelona, Spain.
authors.forename: J V
authors.initials: JV
authors.lastname: Torregrosa
authors.affiliation: Servicio de Nefrología - Clinical Institute of Nephrology and Urology, Hospital Clinic, Barcelona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Campistol
authors.affiliation: Servicio de Nefrología - Clinical Institute of Nephrology and Urology, Hospital Clinic, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Oppenheimer
authors.affiliation: Servicio de Nefrología - Clinical Institute of Nephrology and Urology, Hospital Clinic, Barcelona, Spain. Electronic address: fdiekman@clinic.ub.es.
authors.forename: F
authors.initials: F
authors.lastname: Diekmann
mesh_terms: D006084:Graft Rejection / Q000276:immunology / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000276:immunology / Q000517:prevention & control / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D008875:Middle Aged; D065286:Prophylactic Surgical Procedures / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014184:Transplantation, Homologous