After loss of the first allograft, survival time longer with timely second kidney transplant versus remaining wait-listed and on dialysis
THURSDAY, Dec. 30, 2021 (HealthDay News) — For patients with a failed first kidney transplant, a second transplant results in longer average survival time, but the advantage decreases with time spent on the waiting list, according to a study published online Dec. 27 in the Clinical Journal of the American Society of Nephrology.
Alexander Kainz, Ph.D., from the Medical University of Vienna, and colleagues conducted a retrospective study using data from 2,346 patients with a failed first graft to examine the association of time on the waiting list with patient survival among those receiving a second transplantation versus remaining on the waiting list. The difference in restricted mean survival time (RMST) and hazard ratios for all-cause mortality were compared for “retransplant” and “remain wait-listed with maintenance dialysis” for different waiting times after the first graft loss.
The researchers found that RMST at 10 years of follow-up was longer with a second kidney transplantation versus remaining on the waiting list (5.8 life-months gained). In patients with longer waiting time after loss of the first allograft, this survival difference was attenuated: RMST differences at 10 years were 8.0 and 0.1 life-months gained with a waiting time for retransplantation of less than one year and eight years, respectively.
“If these results are reproduced in imitated trials from other countries, it would signify the importance of decreasing time on the waiting list for second kidney transplant candidates by measures such as expedited workup and enlistment of patients with failing first kidney transplants before they require dialysis,” write the authors of an accompanying editorial.
Several authors disclosed financial ties to the pharmaceutical industry.
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