Renal retransplantation in adults.

For a long time, retransplanted patients were considered to be high-risk subjects, but a number of studies have shown that retransplantation can give good short-term results. Objectives : Between October 1987 and Febrary 1997, 51 retransplanted patients (Group 1) were compared with 96 patients (Group 2), matched for age sex and date of trasplantation, receiving a first kidney with a mean age of 41 +/- 10 years and a mean follow-up of 44 +/- 32 months. Results : The patient did not differ in terms of aetiology of the renal disease, mismatches and duration of dialysis before the first tra,transplant and the duration of dialysis before the second transplant was 53 +/- 54 months. In Group I, transplant loss was due to an immunological [34], surgical [8], or medical [3] cause, or due to recurrence of the disease [3] and discontinuation of treatment [5]. Hyperimmunized subjects were more numerous in Group I : 21.4% vs 5.2% (p<0.01). Immunosuppresion only differed in terms of Cyclosporin : 65% for Group I vs 45% for Group 2 (p<0.05). The two groups did not differ in terms of acute rejection (33% for Group 1 vs 48% for Group 2), serum creatinine at last review (140 +/- 51 +/- 65 m mol/l) and 5-year and 8-year patient (92 vs 82% and 92 vs 76%) and graft survival curves (85 vs 75% and 59 vs 61%). Conclusion : This study confirms that retransplantation can be successfully performed even in terms of long-term results.