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Impact of transplant nephrectomy on retransplantation: a single-center retrospective study

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Abstract

Purpose

Kidney retransplantation is the best treatment option for transplanted patients returning to dialysis. The aim of this study was to explore the effect of removal of a failed graft on the outcome of a subsequent transplant.

Methods

We identified 140 patients who underwent retransplantation at our institution. Retrospective comparison was performed between patients undergoing kidney retransplantation with (group A, n = 28) and without (group B, n = 112) preliminary nephrectomy. Graft and patient survival were calculated by the Kaplan–Meier method.

Results

After a mean follow-up of 64.5 months, patients survival was comparable between the two groups (group A = 68.6 vs. group B = 63.5 months; p = 0.6). Mean graft survival was 65.5 versus 56.0 months in group A and B, respectively (p = 0.14). Surgical complications after retransplantation were significantly higher in group A compared to group B (57.1 vs. 19.6 %; p = 0.0002). There was no significant difference between the two groups in the panel reactive antibody level at the time of retransplantation (group A = 20 % vs. group B = 32 %; p = 0.22). The acute rejection rate was 35.7 % in group A and 25 % in group B (p = 0.36). The risk of delayed graft function was not significantly increased in group A (p = 0.63). Finally, 2 years after retransplantation, patients who had not undergone nephrectomy had lower serum creatinine concentrations (1.3 vs. 1.7 mg/dl; p = 0.01) and higher estimated GFR (77.9 vs. 59.3 ml/min/1.73 m2; p = 0.02).

Conclusion

Our experience shows that there is no advantage in performing allograft nephrectomy before retransplantation, and that this procedure does not seem to significantly influence the survival of a subsequent graft.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy

    Giuseppe Lucarelli, Antonio Vavallo, Carlo Bettocchi, Francesco Paolo Selvaggi, Michele Battaglia & Pasquale Ditonno

  2. Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy

    Vincenzo Losappio & Loreto Gesualdo

  3. Nephrology, Dialysis and Transplantation Unit, Department of Biomedical Sciences, University of Foggia, Foggia, Italy

    Giuseppe Grandaliano

Authors
  1. Giuseppe Lucarelli
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  2. Antonio Vavallo
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  3. Carlo Bettocchi
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  4. Vincenzo Losappio
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  5. Loreto Gesualdo
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  6. Giuseppe Grandaliano
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  7. Francesco Paolo Selvaggi
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  8. Michele Battaglia
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  9. Pasquale Ditonno
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Corresponding author

Correspondence to Giuseppe Lucarelli.

Additional information

Giuseppe Lucarelli and Antonio Vavallo contributed equally to this study.

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Lucarelli, G., Vavallo, A., Bettocchi, C. et al. Impact of transplant nephrectomy on retransplantation: a single-center retrospective study. World J Urol 31, 959–963 (2013). https://doi.org/10.1007/s00345-012-0986-y

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  • DOI: https://doi.org/10.1007/s00345-012-0986-y

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