RECTAL RETRANSPLANTS - EFFECT OF PRIMARY ALLOGRAFT NEPHRECTOMY ON EARLY FUNCTION, ACUTE REJECTION AND OUTCOME

Although risk factors for failure of renal retransplants have been wel l studied, the impact of allograft nephrectomy on subsequent renal tra nsplantation in the cyclosporin era is not well defined. The purpose o f this study is to define the effect of nephrectomy of the primary all ograft on subsequent allograft survival, early allograft function, inc idence of acute rejection and patient sensitization. The records of 12 7 renal retransplant recipients were reviewed. Of these 127 patients w ho underwent retransplantation, 40 (31%) underwent nephrectomy of the primary allograft prior to retransplantation whereas 40 (31%) did not. Nephrectomy of cadaveric primary allografts was performed more common ly (48% vs 30%, p=0.003) and earlier (78% vs 54% <1 month post-transpl ant, p=0.0006) in the pre-CSA period compared to the CSA period. Biops y-proven acute rejection episodes occurred more frequently in the neph rectomy group (73% vs 42%, p=0.03). Although primary allograft nephrec tomy was associated with higher preformed antibody levels, it had no e ffect on early graft function, frequency of acute rejection or allogra ft outcome after retransplantation, in the CSA group. In conclusion, i n the cyclosporin era, nephrectomy of the primary allograft has no sig nificant influence on retransplantation.