Graft Survival in Patients Who Received Second Allograft, Comparing Those With or Without Previous Failed Allograft Nephrectomy

Introduction. Nowadays, the number of patients receiving a second graft is growing, and the management of failed grafts is still controversial. Objective. Our objective was to analyze the influence of graft nephrectomy on graft and patient survival. Materials and Methods. We retrospectively evaluated the demographic features and graft outcomes of 63 recipients who received second allografts between August 1985 and April 2013. They were divided into two groups: group A, those who underwent nephrectomy of failed graft (n = 21, 33.3%), and group B, those whose failed graft was retained (n = 42, 66.6%). chi(2) and Mann-Whitney U tests were used to compare demographic characteristics and graft features in both groups. Kaplan-Meier test was used to analyze graft and patient survival. Finally, univariate and multivariate analysis was done using Cox regression. Results. Demographic characteristics of donor and receptors were similar in both groups. Overall panel-reactive antibody (P =.040) showed statistically significant differences between groups (72.0 +/- 25.3 in group A and 54.8 +/- 30.0 in group B). Hemodialysis duration was longer in group A (P =.023, 112.2 +/- 72.8 vs 70.9 +/- 66.9 months). The percentage of patients who had delayed graft function was higher in group A (58.8% vs 27.3%, P =.029). Kaplan-Meier test found no differences between groups (P =.344); group A, 107.4 months (95% confidence interval [CI] 74.0 to 140.8) and group B, 82.7 months (95% CI 62.5 to 102.8). We found no differences in terms of patient survival (P =.798) with the Kaplan-Meier test. In group A, patient survival was 164.5 months (CI 137.7 to 191.31) and in group B, 152.0 months (95% CI 125.5 to 178.5). Conclusions. Failed graft nephrectomy did not show a negative impact on graft and patient survival.