Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (18): 3271-3275.doi: 10.3969/j.issn.1673-8225.2011.18.011

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Therapeutic outcomes evaluation and multi-factor prognostic analysis of renal retransplantation

Zhao Yu-jun1,2, Cheng Ke1,2, Ming Ying-zi1,2, Liu Lian1,2, Liu Hong1,2, She Xing-guo1,2, YE Qi-fa1,2   

  1. 1Xiangya Transplantation Medical Academy, Third Xiangya Hospital, Central South University, Changsha  410013, Hunan Province, China
    2Research Center of Transplantation Medicine Engineering and Technology, Ministry of Health, Changsha  410013, Hunan Province, China
  • Received:2010-11-03 Revised:2011-03-28 Online:2011-04-30 Published:2011-04-30
  • Contact: Ye Qi-fa, Chief physician, Xiangya Transplantation Medical Academy, Third Xiangya Hospital, Central South University, Changsha 410013, Hunan Province, China; Research Center of Transplantation Medicine Engineering and Technology, Ministry of Health, Changsha 410013, Hunan Province, China yqf_china@163.com
  • About author:Zhao Yu-jun☆, Doctor, Attending physician, Xiangya Transplantation Medical Academy, Third Xiangya Hospital, Central South University, Changsha 410013, Hunan Province, China; Research Center of Transplantation Medicine Engineering and Technology, Ministry of Health, Changsha 410013, Hunan Province, China zyjdoc@yahoo.com.cn

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Abstract:

BACKGROUND: Renal retransplantation has more benefits of used new immunosuppressive agents and improved perioperative management; however, compared with the primary allografts, regrafts face more risk factors. With the shortage of renal donations, it is necessary to assess long-term outcome of regrafts and to identify risk factors associated with long-term graft survial.
OBJECTIVE: To evaluate the therapeutic outcomes of renal retransplantation and analyze the prognostic factors.
METHODS: The clinical and follow-up data of 68 patients who underwent renal retransplantation between April 2001 and June 2009 in Xiangya Transplantation Medical Academy of the Third Xiangya Hospital of Central South University were analyzed retrospectively. The patient/graft survival rates were calculated by Kaplan-Meier method and compared to primary ones performed during the same period. A total of 12 clinical indictors were selected, Log-rank test and Cox proportional hazards regression model were performed to analyze prognostic factors of regraft outcome.
RESULTS AND CONCLUSION: The follow-up time ranged from 6 to 86 months (median, 38.6 months). The mortality was 14.7%, The regraft loss rate was 26.5%. Survival rates at 1-, 3- and 5-year of the patient/graft of retransplantation group were 94.1%/89.7%, 87.3%/80.5% and 80.3%/68.7% respectively，while those at 1-, 3- and 5- years of the patient/graft of the primary renal transplantation were 96.3%/94.5%, 90.5%/85.4% and 83.8%/75.6%, respectively. No significant difference in the patient/graft survival rates was observed between two groups (P > 0.05). Univariate analysis showed that the duration of primary graft survival, peak panel reactive antibody (PRA) level, HLA mismatch，acute rejection, delayed graft function (DGF) and induction therapy were significantly associated with regraft survival. Multivariate Cox regression analysis showed that the duration of primary graft survival, peak PRA level and HLA mismatch were independent prognostic factors of regraft.The regraft had more benefits of improved pre-transplant screening and post-transplant management, and its survival rate was satisfactory and similar to that of primary one. The duration of primary graft survival, peak PRA level and HLA mismatch are main determinants of regraft outcome.

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