Predictors of graft function and survival in second kidney transplantation: A single center experience  

作　　者：Mahmoud Khalil Rabea Ahmed Gadelkareem Medhat Ahmed Abdallah Mohamed Abdel-Basir Sayed FathyGaber Elanany Paolo Fornara Nasreldin Mohammed 

机构地区：[1]Department of Urology,Assiut Urology and Nephrology Hospital,Faculty of Medicine,Assiut University,Assiut 71515,Assiut,Egypt [2]Department of Urology and Kidney Transplantation,Martin Luther University,Halle(Saale)71515,Germany

出　　处：《World Journal of Transplantation》2023年第6期331-343,共13页世界移植杂志

基　　金：this study were approved by the Ethical Committee(Institutional Review Board,IRB)of the Faculty of Medicine,Assiut University,Egypt and Martin-Luther University,Germany(IRB approval number:17200548/2015).

摘　　要：BACKGROUND The increasing kidney retransplantation rate has created a parallel field of research,including the risk factors and outcomes of this advanced form of renal replacement therapy.The presentation of experiences from different kidney transplantation centers may help enrich the literature on kidney retransplantation,as a specific topic in the field of kidney transplantation.AIM To identify the risk factors affecting primary graft function and graft survival rates after second kidney transplantation(SKT).METHODS The records of SKT cases performed between January 1977 and December 2014 at a European tertiary-level kidney transplantation center were retrospectively reviewed and analyzed.Beside the descriptive characteristics,the survivals of patients and both the first and second grafts were described using Kaplan-Meier curves.In addition,Kaplan-Meier analyses were also used to estimate the survival probabilities at 1,3,5,and 10 post-operative years,as well as at the longest followup duration available.Moreover,bivariate associations between various predictors and the categorical outcomes were assessed,using the suitable biostatistical tests,according to the predictor type.RESULTS Out of 1861 cases of kidney transplantation,only 48 cases with SKT were eligible for studying,including 33 men and 15 women with a mean age of 42.1±13 years.The primary non-function(PNF)graft occurred in five patients(10.4%).In bivariate analyses,a high body mass index(P=0.009)and first graft loss due to acute rejection(P=0.025)were the only significant predictors of PNF graft.The second graft survival was reduced by delayed graft function in the first(P=0.008)and second(P<0.001)grafts.However,the effect of acute rejection within the first year after the first transplant did not reach the threshold of significance(P=0.053).The mean follow-up period was 59.8±48.6 mo.Censored graft/patient survival rates at 1,3,5 and 10 years were 90.5%/97.9%,79.9%/95.6%,73.7%/91.9%,and 51.6%/83.0%,respectively.CONCLUSION Non-immediate recovery mode

关 键 词：Graft failure Graft function KIDNEY Kidney retransplantation Primary non-function graft Second kidney transplantation 

分 类 号：R69[医药卫生—泌尿科学]