Renal retransplantation in adults.

For a long time, retransplanted patients were considered to be high-risk su bjects, but a number of studies have shown that retransplantation can give good short-term results. Objectives : Between October 1987 and Febrary 1997, 51 retransplanted patie nts (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 dis ease, mismatches and duration of dialysis before the first tra,transplant a nd the duration of dialysis before the second transplant was 53 +/- 54 mont hs. 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 disc ontinuation 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 group s did not differ in terms of acute rejection (33% for Group 1 vs 48% for Gr oup 2), serum creatinine at last review (140 +/- 51 +/- 65 m mol/l) and 5-y ear 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.