title: Graft Survival in Patients Who Received Second Allograft, Comparing Those With or Without Previous Failed Allograft Nephrectomy.
abstract: BACKGROUND
  Nowadays, the number of patients receiving a second graft is growing, and the management of failed grafts is still controversial.
  
  
  OBJECTIVE
  Our objective was to analyze the influence of graft nephrectomy on graft and patient survival.
  
  
  METHODS
  We retrospectively evaluated the demographic features and graft outcomes of 63 recipients who received second allografts between August 1985 and April 2013. They were divided into two groups: group A, those who underwent nephrectomy of failed graft (n = 21, 33.3%), and group B, those whose failed graft was retained (n = 42, 66.6%). χ2and Mann-Whitney U tests were used to compare demographic characteristics and graft features in both groups. Kaplan-Meier test was used to analyze graft and patient survival. Finally, univariate and multivariate analysis was done using Cox regression.
  
  
  RESULTS
  Demographic characteristics of donor and receptors were similar in both groups. Overall panel-reactive antibody (P = .040) showed statistically significant differences between groups (72.0 ± 25.3 in group A and 54.8 ± 30.0 in group B). Hemodialysis duration was longer in group A (P = .023, 112.2 ± 72.8 vs 70.9 ± 66.9 months). The percentage of patients who had delayed graft function was higher in group A (58.8% vs 27.3%, P = .029). Kaplan-Meier test found no differences between groups (P = .344); group A, 107.4 months (95% confidence interval [CI] 74.0 to 140.8) and group B, 82.7 months (95% CI 62.5 to 102.8). We found no differences in terms of patient survival (P = .798) with the Kaplan-Meier test. In group A, patient survival was 164.5 months (CI 137.7 to 191.31) and in group B, 152.0 months (95% CI 125.5 to 178.5).
  
  
  CONCLUSIONS
  Failed graft nephrectomy did not show a negative impact on graft and patient survival.
authors.affiliation: Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain. Electronic address: alvarosangon@gmail.com.
authors.forename: Á
authors.initials: Á
authors.lastname: Sánchez-González
authors.affiliation: Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Carrasco-Valiente
authors.affiliation: Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
authors.forename: A J
authors.initials: AJ
authors.lastname: Arenas-Bonilla
authors.affiliation: Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
authors.forename: J P
authors.initials: JP
authors.lastname: Campos-Hernández
authors.affiliation: Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Blanca-Pedregosa
authors.affiliation: Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Ruíz-García
authors.affiliation: Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Valero-Rosa
authors.affiliation: Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Gómez-Gómez
authors.affiliation: Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
authors.forename: J J
authors.initials: JJ
authors.lastname: Salamanca-Bustos
authors.affiliation: Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Navarro-Cabello
authors.affiliation: Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Requena-Tapia
mesh_terms: D000328:Adult; D064591:Allografts / Q000502:physiology*; D051799:Delayed Graft Function / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000401:mortality* / Q000503:physiopathology; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009392:Nephrectomy / Q000401:mortality*; D006435:Renal Dialysis / Q000401:mortality; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000401:mortality
chemical_list: D007166:Immunosuppressive Agents