Abstract
From January 1, 1968 to December 31, 1973, 50 patients received two or more kidney transplants. Patient and graft survival was highly dependent upon the source of the donor and to a lesser extent the functional duration of the first transplant and the elapsed time between first and second graft. Survival (patient and graft) was best in patients receiving two related grafts and worst in patients receiving two sequential cadaver grafts. Intermediate rates of success followed cadaver transplantation after rejection of a related graft. The highest failure rate was encountered when those patients who sustained an early loss of the first cadaver graft received a subsequent cadaver graft within a few months. We recommended removal of the acutely rejected graft and delay prior to retransplantation of patients who rapidly reject cadaver grafts in the face of maximal doses of immunosuppression. A delay will permit recovery from both the immunosuppression and any underlying subclinical infections, and will permit the recognition of anti-HL-A antibodies which may not be manifest soon after rejection. Retransplantation of the patient who is slowly rejecting the first kidney does not require prior removal of the rejected graft or delay in retransplantation.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Callender C. O., Simmons R. L., Yunis E. J., Toledo-Pereyra L. H., DeShazo M. T., Najarian J. S. Anti-HL-A antibodies: Failure to correlate with renal allograft rejection. Surgery. 1974 Oct;76(4):573–580. [PubMed] [Google Scholar]
- Gustafsson A., Groth C. G., Halgrimson C. G., Penn I., Starzl T. E. The fate of failed renal homografts retained after retransplantation. Surg Gynecol Obstet. 1973 Jul;137(1):40–42. [PMC free article] [PubMed] [Google Scholar]
- Husberg B. S., Starzl T. E. Proceedings: The outcome of kidney retransplantation. Arch Surg. 1974 Apr;108(4):584–587. doi: 10.1001/archsurg.1974.01350280184030. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kountz S. L., Belzer F. O. The fate of patients after renal transplantation, graft rejection, and retransplantation. Ann Surg. 1972 Oct;176(4):509–520. doi: 10.1097/00000658-197210000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MERRELL M., SHULMAN L. E. Determination of prognosis in chronic disease, illustrated by systemic lupus erythematosus. J Chronic Dis. 1955 Jan;1(1):12–32. doi: 10.1016/0021-9681(55)90018-7. [DOI] [PubMed] [Google Scholar]
- Najarian J. S., Simmons R. L. The clinical use of antilymphocyte globulin. N Engl J Med. 1971 Jul 15;285(3):158–166. doi: 10.1056/NEJM197107152850310. [DOI] [PubMed] [Google Scholar]
- Opelz G., Mickey M. R., Terasaki P. I. Identification of unresponsive kidney-transplant recipients. Lancet. 1972 Apr 22;1(7756):868–871. doi: 10.1016/s0140-6736(72)90739-8. [DOI] [PubMed] [Google Scholar]
- Opelz G., Mickey M. R., Terasaki P. I. Prolonged survival of second human kidney transplants. Science. 1972 Nov 10;178(4061):617–619. doi: 10.1126/science.178.4061.617. [DOI] [PubMed] [Google Scholar]
- Opelz G., Terasaki P. I. Second kidney transplants and presensitization. Transplant Proc. 1972 Dec;4(4):743–748. [PubMed] [Google Scholar]
- Spanos P. K., Simmons R. L., Rattazzi L. C., Kjellstrand C. M., Buselmeier T. J., Najarian J. S. Peptic ulcer disease in the transplant recipient. Arch Surg. 1974 Aug;109(2):193–197. doi: 10.1001/archsurg.1974.01360020055011. [DOI] [PubMed] [Google Scholar]
- Woods J. E., Anderson C. F., Johnson W. J., Donadio J. V., Jr, Frohnert P. P., Leary F. J., DeWeerd J. H., Taswell H. F. Experience with renal transplantation in high risk patients. Surg Gynecol Obstet. 1973 Sep;137(3):393–398. [PubMed] [Google Scholar]