Retrasplante renal: factores de riesgo y resultados

objective: to review our experience in renal retransplantations. materials and methods: we carried out a retrospective study on 71 patients with retransplantation performed between 1980 and 2005. we studied: the characteristics of the recipient and graft, surgery data, causes of loss of the graft, number of rejects and transplantectomies and, survival of the graft. results: the most frequent cause of graft loss was chronic rejection. the causes of first graft loss were not associated with a greater loss of the second graft (p>0.05). the percentage of anti-hla antibodies increased in the second transplant in comparison to the first (17.23±27.91% vs. 1.21±7.43%) (p=0.001), however, it was not correlated with a significant increase in loss of the second graft (p=0.320). there were no significant differences between the complications of the first and second transplants (p>0.05) and they were not associated with graft loss (p>0.05). the patients with a transplantectomy in the first transplant presented a risk 8.5 times higher of undergoing a second one (p=0.0001; or: 8.54; ci: 95% 0.941 - 77.501). the most frequent cause of transplantectomies in the second transplant was acute rejection. acute rejection as a cause for transplantectomy in the first transplant proved to be an independent risk factor of transplantectomy of the second transplant (p=0.009). the mean survival of the second graft was 5.08±4.81 years, higher than the first transplant (p=0.133). the survival of the graft at 1.5 and 10 years was 83%, 75% and 52%, respectively. conclusions: the survival of the second transplant was not lower than the first, neither was there an increase in the number of complications.