Introduction: Patients who get started on dialysis after loss of kidney graft function are candidates for retransplantation. Specific characteristics of these patients related to kidney graft survival could be evaluated in terms of planning for their retransplantation.
Method: Eighty-three patients (54 men) who were on dialysis after loss of kidney graft function were studied. The duration of graft survival, the initial dialysis vintage, HLA compatibility, rejection episodes, and the occurrence of post-transplant diabetes mellitus and cardiac comorbidity were assessed.
Results: Graft survival was 13.3 ± 6.2 years with 66% of patients recording a relative survival of more than 10 years. Younger age of patients at transplantation was associated with a higher probability of graft survival of more than 10 years (t=2.71, p=0.008). Re-enrollment on dialysis occurred later in patients who had received a living donor graft (log-rank x²=9.81, p=0.002) and had been on dialysis for less than five years prior to transplantation (log-rank x²=6.88, p=0.009). Post-transplant diabetes mellitus and cardiac comorbidity were reported in 19% and 31% of patients, respectively, but did not affect graft survival. After starting dialysis, 35% of patients were re-listed to receive a deceased donor graft.
Conclusions: Early donation from a living donor led to longer kidney graft survival, particularly in younger patients who were eventually reintroduced to dialysis. A significant proportion of these patients are candidates for retransplantation from a deceased donor.