Borroto DG

Language: Spanish
References: 25
Page: 165-177
PDF size: 234.08 Kb.

ABSTRACT

Introduction: retransplant constitutes the best therapeutic choice for patients who lose a first renal transplant and return to dialysis, existing dissimilar criteria as to its results when ranking them with renal primary transplant.
Objective: to analyze the percentage of retransplantation, to revise graft and patient survival, to review the behavior of variables that can affect the results and to compare them with patients receiving a first renal transplant.
Methods: an analytic, descriptive, retrospective study was accomplished, including all renal transplant performed at the Hermanos Ameijeiras Hospital from 1984 to December of 2012. Third transplants, double transplants (two kidneys to the same receptor), combined transplants (pancreas-kidney and liver-kidney) and those where it was not possible to obtain the information required for this research were excluded. Variables of general nature were compared between retransplantation groups and first transplants, such as: age of recipient and donor, sex of the recipient, a disease that caused kidney failure, percentage of reactivity to a lymphocyte panel (PRA), HLA compatibility, donor type (living or dead), ischemia time, presence and duration of acute tubular necrosis (dead donor), rejection and graft and patient survival.
Results: Retransplant constituted only 5.4 % of the sample (34 patients). There were no differences in age, sex, PRA, donor type or compatibilities between the second and first grafts. Patients who reached the renal failure due to polycystic kidneys have never had a second transplant in our institution. The use of sequential quadruple therapy as induction immunosuppression, retransplantation (55.9 % vs. 9.7 % of primary) was statistically significant. The rejection rate was slightly lower in those receiving a second graft, but it was different for ischemic times, the presence and duration of NTA and graft survival which were very similar in both groups.
Conclusiones: retransplant constitutes the best therapeutic choice for patients who lose a first renal transplant and return to dialysis methods.

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