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. 2022 Aug;22(8):2028-2040.
doi: 10.1111/ajt.17081. Epub 2022 May 24.

Association between kidney retransplantation and survival according to age in the French national cohort of dialysis patients

Sophie Girerd  1   2 , Kevin Duarte  1 , Cécile Couchoud  3 , Emmanuelle Laurain  2 , Cécile Courivaud  4 , Marc Bauwens  5 , Michèle Kessler  2 , Luc Frimat  2 , Nicolas Girerd  1
Affiliations

Association between kidney retransplantation and survival according to age in the French national cohort of dialysis patients

Sophie Girerd et al. Am J Transplant. 2022 Aug.

Abstract

The mean age of patients returning to dialysis after a first kidney transplantation (KT) has increased in the past decades. We aimed to assess the association between second KT (2KT) and survival according to age at the time of return to dialysis. Data of 5334 patients registered in the French Renal Epidemiology and Information Network (REIN) (mean age 56.6 ± 13.6 years) who returned to dialysis after a first KT were collected. The association of 2KT with death was assessed using a propensity score-based analysis taking into account baseline and follow-up variables. In relisted patients (3272 patients, 61.3%), retransplantation was associated with better overall survival in comparison with patients who remained in dialysis (adjusted HR 0.75 [0.63-0.89], p = .0009). The survival advantage conferred by retransplantation gradually declined with increasing age (adjusted HR 0.41 [0.24-0.70] in patients <50, HR 0.94 (0.69-1.27) in patients aged 70 or older, p for interaction 0.034 for age considered as a continuous variable). 2KT is associated with better survival as opposed to remaining on dialysis after a first kidney graft failure. Nevertheless, this survival benefit is age dependent and diminishes with increasing age. The risk/benefit ratio should be comprehensively assessed in the oldest patients when relisting is considered.

Keywords: dialysis; kidney transplantation; second kidney transplantation; survival.

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Figures

FIGURE 1
FIGURE 1
Flow‐chart [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 2
FIGURE 2
Association between relisting or retransplantation and mortality according to age (weighted Cox models)
FIGURE 3
FIGURE 3
Association between retransplantation and mortality according to age (HR for comparison between patients retransplanted versus patients relisted but not retransplanted) [Color figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

References

    1. Ojo AO, Wolfe RA, Agodoa LY, et al. Prognosis after primary renal transplant failure and the beneficial effects of repeat transplantation: multivariate analyses from the United States Renal Data System. Transplantation. 1998;66(12):1651‐1659. - PubMed
    1. Rao PS, Schaubel DE, Wei G, Fenton SS. Evaluating the survival benefit of kidney retransplantation. Transplantation. 2006;82(5):669‐674. - PubMed
    1. Rapport 2018 du REIN. Accessed October 15, 2021. https://www.agence‐biomedecine.fr/IMG/pdf/rapport_rein_2018_v2.pdf
    1. The Australia and New Zealand Dialysis and Transplant Registry (ANZDATA). Accessed October 15, 2021. http://www.anzdata.org.au/v1/index.html
    1. Le rapport médical et scientifique 2019 du prélèvement et de la greffe en France. Accessed October 15, 2021. https://rams.agence‐biomedecine.fr/greffe‐renale‐0

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