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. 2010 Feb;21(2):374-80.
doi: 10.1681/ASN.2009050480. Epub 2009 Oct 29.

Transplant nephrectomy improves survival following a failed renal allograft

Juan Carlos Ayus  1 , Steven G Achinger, Shuko Lee, Mohamed H Sayegh, Alan S Go
Affiliations

Transplant nephrectomy improves survival following a failed renal allograft

Juan Carlos Ayus et al. J Am Soc Nephrol. 2010 Feb.

Abstract

There is a growing number of patients returning to dialysis after a failed kidney transplant, and there is increasing evidence of higher mortality among this population. Whether removal of the failed renal allograft affects survival while receiving long-term dialysis is not well understood. We identified all adults who received a kidney transplant and returned to long-term dialysis after renal allograft failure between January 1994 and December 2004 from the US Renal Data System. Among 10,951 transplant recipients who returned to long-term dialysis, 3451 (31.5%) received an allograft nephrectomy during follow-up. Overall, 34.6% of these patients died during follow-up. Receiving an allograft nephrectomy associated with a 32% lower adjusted relative risk for all-cause death (adjusted hazard ratio 0.68; 95% confidence interval 0.63 to 0.74) after adjustment for sociodemographic characteristics, comorbidity burden, donor characteristics, interim clinical conditions associated with receiving allograft nephrectomy, and propensity to receive an allograft nephrectomy. In conclusion, within a large, nationally representative sample of high-risk patients returning to long-term dialysis after failed kidney transplant, receipt of allograft nephrectomy independently associated with improved survival.

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Figures

Figure 1.
Figure 1.
Assembly of analysis cohort of 10,951 patients who returned to maintenance dialysis after a failed kidney transplant between 1994 and 2004 in the USRDS is shown.
Figure 2.
Figure 2.
Unadjusted rate of death from any cause associated with or without receipt of renal allograft nephrectomy in 10,951 patients returning to maintenance dialysis after a failed kidney transplant between January 1, 1994, and December 31, 2004, is shown.
Figure 3.
Figure 3.
Unadjusted rate of repeat transplantation associated with or without receipt of previous renal allograft nephrectomy in 10,951 patients returning to maintenance dialysis after a failed kidney transplant between January 1, 1994, and December 31, 2004, is shown.
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References

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