INTRODUCTION: Allosensitization is a significant obstacle to retransplantation for patients with primary renal graft failure. METHODS: We assessed the impact of allograft nephrectomy (Group I) and weaning of immunosuppression (Group II) on percent panel reactive antibody (%PRA) at various time points after graft failure in 132 patients with a median follow-up of 47 months. Of these, 68% had allograft nephrectomy while 32% were placed on the waiting list and were either taken off immunosuppression, left on prednisone or on low-dose immunosuppressive therapy. RESULTS: When groups were stratified into early (<6 months) and late (>6 months) graft failure, patients who had transplant nephrectomy for early failure demonstrated a decline in %PRA from 46% at time of graft failure to 27% at last follow-up (p = 0.02); conversely, %PRA continued to rise in Group II experiencing early allograft failure. Both Groups I and II patients with late graft failure maintained elevated %PRA at last follow-up. CONCLUSION: Allograft nephrectomy may play a role in limiting allosensitization in patients with early but not late graft failures.
INTRODUCTION: Allosensitization is a significant obstacle to retransplantation for patients with primary renal graft failure. METHODS: We assessed the impact of allograft nephrectomy (Group I) and weaning of immunosuppression (Group II) on percent panel reactive antibody (%PRA) at various time points after graft failure in 132 patients with a median follow-up of 47 months. Of these, 68% had allograft nephrectomy while 32% were placed on the waiting list and were either taken off immunosuppression, left on prednisone or on low-dose immunosuppressive therapy. RESULTS: When groups were stratified into early (<6 months) and late (>6 months) graft failure, patients who had transplant nephrectomy for early failure demonstrated a decline in %PRA from 46% at time of graft failure to 27% at last follow-up (p = 0.02); conversely, %PRA continued to rise in Group II experiencing early allograft failure. Both Groups I and II patients with late graft failure maintained elevated %PRA at last follow-up. CONCLUSION: Allograft nephrectomy may play a role in limiting allosensitization in patients with early but not late graft failures.
Authors: C Noel; M Hazzan; M Boukelmoune; S Jaillard; F Dufossé; M X Codaccioni; F R Pruvot; G Lelièvre Journal: Transplant Proc Date: 1997 Feb-Mar Impact factor: 1.066
Authors: P J Smak Gregoor; R Zietse; J L van Saase; C T op de Hoek; J N IJzermans; A T Lavrijssen; G M de Jong; P Kramer; W Weimar Journal: Clin Transplant Date: 2001-12 Impact factor: 2.863
Authors: Loes Oomen; Charlotte Bootsma-Robroeks; Elisabeth Cornelissen; Liesbeth de Wall; Wout Feitz Journal: Front Pediatr Date: 2022-04-08 Impact factor: 3.569