title: Kidney Transplant Outcomes After Primary, Repeat and Kidney After Nonrenal Solid Organ Transplantation: A Single-Center Experience.
abstract: BACKGROUND
  Improvements in renal allograft outcomes have permitted kidney transplantation after prior kidney allograft failure as well as after nonrenal solid organ transplantation. This study compares renal allograft outcomes in the 3 groups, that is, primary, repeat, and kidney after nonrenal solid organ transplantation, where transplant group was coded as a time-dependent variable.
  
  
  METHODS
  We retrospectively reviewed registry data for kidney transplant recipients at University of Pittsburgh Medical Center from January 2000 to December 2011. We compared overall graft survival between the 3 groups using Cox regression modeling. We calculated 1-, 3-, and 5-year graft survival and half-lives for each group where feasible.
  
  
  RESULTS
  The study cohort (N = 2014) consisted of group A (primary kidney transplant, n = 1578, with 7923.2 years of follow-up time), group B (repeat kidney transplant, n = 314, with 1566.7 years of follow-up time) and group C (kidney post-nonrenal solid organ transplant, n = 176, with 844.8 years of follow-up time). Of the 1578 patients in the primary kidney transplant group, 74 later received a repeat transplant and thus also have follow-up counted in the repeat kidney transplant group. The median follow-up was 56, 53, and 55 months, respectively. The 5-year actuarial and death-censored graft survival was 68.69%, 68.79%, and 66.48% and 65.53%, 67.68%, and 62.92%, respectively (P = 0.70). There was no difference in overall graft survival in the Cox-adjusted analysis (group B: odds ratio, 1.02; 95% confidence interval, 0.84-1.26; P = 0.79; group C: odds ratio, 0.96; 95% confidence interval, 0.75-1.23; P = 0.76).
  
  
  CONCLUSIONS
  The adjusted kidney graft survivals in the 3 groups were similar.
authors: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors: Puneet
authors: P
authors: Sood
authors: Section on Biomarkers and Prediction Modeling, University of Pittsburgh Medical Center, Pittsburgh, PA.; Department of Biostatistics, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors: Xiaotian
authors: X
authors: Gao
authors: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors: Rajil
authors: R
authors: Mehta
authors: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.; Section on Biomarkers and Prediction Modeling, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors: Douglas
authors: D
authors: Landsittel
authors: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors: Christine
authors: C
authors: Wu
authors: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors: Rabeeya
authors: R
authors: Nusrat
authors: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors: Chethan
authors: C
authors: Puttarajappa
authors: Division of Transplant Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors: Amit D
authors: AD
authors: Tevar
authors: Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors: Sundaram
authors: S
authors: Hariharan