Renal retransplantation in patients with HLA-antibodies
The results of 92 consecutive renal retransplantations, performed during a 5-year period in recipients with HLA-antibodies, were retrospectively analysed. The actuarial 1-year graft survival (1-y GS) was 65% for all retransplantations, as compared with 63% for first grafts in sensitized recipients. For the second (n = 56), third (n = 24) and fourth-fifth (n = 12) grafts 1-y GS was 64%, 71% and 58%, respectively. Acute rejection was the major cause of graft loss (45%). Recipients with > 3 years GS of the preceding transplant had significantly better GS at retransplantation. Also, grafts with no HLA mismatches had significantly prolonged GS. One-y GS was 78% when PRA (panel reacting antibody) was less than 50%, and 60% when PRA was more than 50%. A benefit of repeated mismatches was demonstrated in the subgroup with PRA <50%, in contrast to recipients with PRA >50%, suggesting that, in some patients, an absence of antibody response against certain antigens might be used as a basis for future deliberate mismatching.
Key wordsRenal retransplantation HLA antibodies Graft survival
Unable to display preview. Download preview PDF.
- 2.Barger BO, Shroyer TW, Hudson SL, Deierhoi MH, Barber WH, Curtis JJ, Mien BA, Luke RG, Diethelm AG (1988) Early graft loss in cyclosporin A treated cadaveric renal allograft recipients receiving retransplants against previous mismatched HLA-A, B-, DR-donor antigens. Transplant Proc 20:170–172Google Scholar
- 3.Opelz G for the Collaboratory Transplant Study. (1987) Transplant Proc 19:641Google Scholar