Abstract: TH-PO744
Evaluating the Impact of Multiple Kidney Retransplants on Post-transplant Outcomes: An Analysis of the OPTN/UNOS Database
Session Information
- Transplantation: Clinical - 1
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Garcia Valencia, Oscar Alejandro, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Thongprayoon, Charat, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Miao, Jing, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Craici, Iasmina, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Leeaphorn, Napat, Mayo Clinic in Florida, Jacksonville, Florida, United States
- Cheungpasitporn, Wisit, Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background
Kidney transplantation offers a valuable therapeutic option for patients esperiencing graft failure after their initial transplant. There is a increasing trend of patients undergoing multiple retransplants however the impact of these subsequent procedures remains understudied. This study evaluated the assocaition between the number of kidney retransplants and patient outcomes.
Methods
Using the OPTN/UNOS database, we identified all kidney-only retransplants in the United States from 2010 to 2019. We categorized them into two groups: those with a first kidney retransplant and those with two or more. The study analyzed the association between multiple retransplants and outcomes such as death-censored graft failure, patient mortality, and acute rejection through Cox proportional hazard and logistic regression analyses.
Results
Of the 17,433 recipients of kidney retransplants included, 15,821 (91%) received one retransplant, while 1,612 (9%) underwent two or more . The latter group tended to be younger, more frequently white, had higher PRA levels, used public insurance, and attained higher education levels. However, they had a lower prevalence of DM and total HLA mismatch compared to individuals with a single kidney retransplant. Multivariate analysis revealed that multiple retransplants significantly increased the risk of death-censored graft failure and acute rejection, albeit it did not significantly impact patient mortality.
Conclusion
Patients undergoing multiple kidney retransplants face a higher risk of graft failure and rejection compared to those with a single retransplant. These findings highlight the need for tailored management and surveillance strategies to improve outcomes for patients receiving multiple kidney retransplants.