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Considerations in Retransplantation of the Failed Renal Allograft Recipient

  • Matthew J. Koch
    Correspondence
    Address Correspondence to Matthew J. Koch, MD, Division of Nephrology, Washington University/Barnes-Jewish Hospital, 6107 Queeny Tower, One Barnes-Jewish Hospital Plaza Campus Box 8126, St. Louis, MO 63110.
    Affiliations
    Department of Medicine, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, MO.
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      Routine success in kidney transplantation has significantly improved the quality and length of life for the majority of recipients and made this option the treatment of choice for suitable candidates. Improved patient survival combined with a relative static improvement in long-term graft outcomes has led to an increasing number of transplant recipients with failed allografts who face the eventual option of either returning to dialysis or seeking retransplantation. Although retransplantation is presumed to be a favorable option for many, data to support this belief is limited. Given the wide variance in predicted outcomes for retransplantation, on the basis of the underlying kidney disease and other individual patient comorbidities as well as the expected wait time for a second transplant, each case should be evaluated independently. This review discusses available data and individual considerations that should be taken into account when retransplantation is proposed after failure of a primary allograft.

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      References

        • Wolfe R.A.
        • Ashby V.B.
        • Milford E.L.
        • et al.
        Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant.
        N Engl J Med. 1999; 341: 1725-1730
        • Meier-Kriesche H.U.
        • Port F.K.
        • Ojo A.O.
        • et al.
        Effect of waiting time on renal transplant outcome.
        Kidney Int. 2000; 58: 1311-1317
        • Meier-Kriesche H.U.
        • Kaplan B.
        Waiting time on dialysis as the strongest modifiable risk factor for renal transplant outcomes.
        Transplantation. 2002; 74: 1377-1381
        • Meier-Kriesche H.U.
        • Schold J.D.
        • Kaplan B.
        Long-term renal allograft survival.
        Am J Transplant. 2004; 4: 1289-1295
        • U.S. Renal Data System
        USRDS 2004 Annual Data Report. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD2004
      1. 2004 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients: Transplant Data 1994-2003. Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation, Rockville, MD; United Network for Organ Sharing, Richmond, VA; University Renal Research and Education Association, Ann Arbor, MI.

        • Raju D.L.
        • Grover V.K.
        • Shoker A.
        Limitations of glomerular filtration rate equations in the renal transplant patient.
        Clin Transplant. 2005; 19: 259-268
        • Vincenti F.
        • Ghiggeri G.M.
        New insights into the pathogenesis and the therapy of recurrent focal glomerulosclerosis.
        Am J Transplant. 2005; 5: 1179-1185
        • Pinto J.
        • Lacerda G.
        • Cameron J.S.
        • et al.
        Recurrence of focal segmental glomerulosclerosis in renal allografts.
        Transplantation. 1981; 32: 83-89
        • Stephanian E.
        • Matas A.J.
        • Mauer S.M.
        • et al.
        Recurrence of disease in patients retransplanted for focal segmental glomerulosclerosis.
        Transplantation. 1992; 53: 755-757
        • Bumgardner G.L.
        • Amend W.C.
        • Ascher N.L.
        • et al.
        Single-center long-term results of renal transplantation for IgA nephropathy.
        Transplantation. 1998; 65: 1053-1060
        • Ohmacht C.
        • Kliem V.
        • Burg M.
        • et al.
        Recurrent immunoglobulin A nephropathy after renal transplantation.
        Transplantation. 1997; 64: 1493-1496
        • Freese P.
        • Svalander C.
        • Norden G.
        • et al.
        Clinical risk factors for recurrence of IgA nephropathy.
        Clin Transplant. 1999; 13: 313-317
        • Kim Y.S.
        • Moon J.I.
        • Jeong H.J.
        • et al.
        Live donor renal allograft in end-stage renal failure patients from immunoglobulin A nephropathy.
        Transplantation. 2001; 71: 233-238
        • Frohnert P.P.
        • Donadio Jr, J.V.
        • Velosa J.A.
        • et al.
        The fate of renal transplants in patients with IgA nephropathy.
        Clin Transplant. 1997; 11: 127-133
        • Ponticelli C.
        • Traversi L.
        • Feliciani A.
        • et al.
        Kidney transplantation in patients with IgA mesangial glomerulonephritis.
        Kidney Int. 2001; 60: 1948-1954
        • Wang A.Y.
        • Lai F.M.
        • Yu A.W.
        • et al.
        Recurrent IgA nephropathy in renal transplant allografts.
        Am J Kidney Dis. 2001; 38: 588-596
        • Cruzado J.M.
        Recurrent glomerulonephritis and risk of renal allograft loss.
        N Engl J Med. 2002; 347: 1531-1532
        • Ramos E.
        • Vincenti F.
        • Lu W.X.
        • et al.
        Retransplantation in patients with graft loss caused by polyoma virus nephropathy.
        Transplantation. 2004; 77: 131-133
        • Ginevri F.
        • Pastorino N.
        • de Santis R.
        • et al.
        Retransplantation after kidney graft loss due to polyoma BK virus nephropathy.
        Am J Kidney Dis. 2003; 42: 821-825
        • Ojo A.
        • Wolfe R.A.
        • Agodoa L.Y.
        • et al.
        Prognosis after primary renal transplant failure and the beneficial effects of repeat transplantation.
        Transplantation. 1998; 66: 1651-1659
        • Kaplan B.
        • Meier-Kriesche H.U.
        Death after graft loss.
        Am J Transplant. 2002; 2: 970-974
        • Rao P.S.
        • Schaubel D.E.
        • Saran R.
        Impact of graft failure on patient survival on dialysis.
        Nephrol Dial Transplant. 2005; 20: 387-391
        • Sung R.S.
        • Guidinger M.K.
        • Lake C.D.
        • et al.
        Impact of the expanded criteria donor allocation system on the use of expanded criteria donor kidneys.
        Transplantation. 2005; 79: 1257-1261
        • Sellers M.T.
        • Velidedeoglu E.
        • Bloom R.D.
        • et al.
        Expanded-criteria donor kidneys.
        Transplantation. 2004; 78: 1670-1675
        • Cosio F.G.
        • Kudva Y.
        • van der Velde M.
        • et al.
        New onset hyperglycemia and diabetes are associated with increased cardiovascular risk after kidney transplantation.
        Kidney Int. 2005; 67: 2415-2421
        • Karras A.
        • Thervet E.
        • Le Meur Y.
        • et al.
        Successful renal retransplantation after post-transplant lymphoproliferative disease.
        Am J Transplant. 2004; 4: 1904-1909
        • Farney A.C.
        • Matas A.J.
        • Noreen H.J.
        • et al.
        Does re-exposure to mismatched HLA antigens decrease renal re-transplant allograft survival?.
        Clin Transplant. 1996; 10: 147-156
        • Jordan S.C.
        • Vo A.
        • Bunnapradist S.
        • et al.
        Intravenous immune globulin treatment inhibits crossmatch positivity and allows for successful transplantation of incompatible organs in living-donor and cadaver recipients.
        Transplantation. 2003; 76: 631-636
        • Montgomery R.A.
        • Zachary A.A.
        • Racusen L.C.
        • et al.
        Plasmapheresis and intravenous immune globulin provides effective rescue therapy for refractory humoral rejection and allows kidneys to be successfully transplanted into cross-match-positive recipients.
        Transplantation. 2000; 70: 887-895
        • Akalin E.
        • Ames S.
        • Sehgal V.
        • et al.
        Intravenous immunoglobulin and thymoglobulin facilitate kidney transplantation in complement-dependent cytotoxicity B-cell and flow cytometry T- or B-cell crossmatch-positive patients.
        Transplantation. 2003; 76: 1444-1447
        • Gloor J.M.
        • Lager D.J.
        • Moore S.B.
        • et al.
        ABO-incompatible kidney transplantation using both A2 and non-A2 living donors.
        Transplantation. 2003; 75: 971-977
        • Takahashi K.
        • Saito K.
        • Takahara S.
        • et al.
        Excellent long-term outcome of ABO-incompatible living donor kidney transplantation in Japan.
        Am J Transplant. 2004; 4: 1089-1096