Graft Survival in Patients Who Received Second Allograft, Comparing Those With or Without Previous Failed Allograft Nephrectomy.

Autor: Sánchez-González Á; Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain. Electronic address: alvarosangon@gmail.com., Carrasco-Valiente J; Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain., Arenas-Bonilla AJ; Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain., Campos-Hernández JP; Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain., Blanca-Pedregosa A; Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain., Ruíz-García JM; Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain., Valero-Rosa J; Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain., Gómez-Gómez E; Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain., Salamanca-Bustos JJ; Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain., Navarro-Cabello D; Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain., Requena-Tapia MJ; Department of Urology, Hospital Universitario Reina Sofía-IMIBIC, Córdoba, Spain.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2016 Nov; Vol. 48 (9), pp. 2895-2898.
DOI: 10.1016/j.transproceed.2016.09.016
Abstrakt: Introduction: 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.
Materials and 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%). χ 2 and 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.
(Copyright © 2016 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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