2008 JASN IMPACT FACTOR 7.505	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) Supplemental Data All Versions of this Article: ASN.2009050480v1 ASN.2009050480v2 21/2/374    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Ayus, J. C. Articles by Go, A. S. PubMed PubMed Citation Articles by Ayus, J. C. Articles by Go, A. S. Related Collections Related Articles

Transplant Nephrectomy Improves Survival following a Failed Renal Allograft

Juan Carlos Ayus^*, Steven G. Achinger, Shuko Lee, Mohamed H. Sayegh and Alan S. Go^||,¶

*Department of Clinical Research, Renal Consultants of Houston, Houston, Texas;
Physicians Clinical Research, San Antonio, Texas;
Veterans Administration Hospital, San Antonio, Texas;
Transplantation Research Center, Renal Division, Brigham and Women's Hospital and Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts;
^||Division of Research, Kaiser Permanente of Northern California, Oakland, California; and
^¶Departments of Epidemiology, Biostatistics, and Medicine, University of California at San Francisco, San Francisco, California

Correspondence: Dr. Juan Carlos Ayus, Department of Clinical Research, Renal Consultants of Houston, 2412 Westgate Street, Houston, TX. Phone: 713-502-0543; Fax: 713-942-9342; E-mail: carlosayus{at}yahoo.com

Received for publication May 5, 2009. Accepted for publication August 30, 2009.

There is a growing number of patients returning to dialysis after a failed kidney transplant, and there is increasing evidence of higher mortality among this population. Whether removal of the failed renal allograft affects survival while receiving long-term dialysis is not well understood. We identified all adults who received a kidney transplant and returned to long-term dialysis after renal allograft failure between January 1994 and December 2004 from the US Renal Data System. Among 10,951 transplant recipients who returned to long-term dialysis, 3451 (31.5%) received an allograft nephrectomy during follow-up. Overall, 34.6% of these patients died during follow-up. Receiving an allograft nephrectomy associated with a 32% lower adjusted relative risk for all-cause death (adjusted hazard ratio 0.68; 95% confidence interval 0.63 to 0.74) after adjustment for sociodemographic characteristics, comorbidity burden, donor characteristics, interim clinical conditions associated with receiving allograft nephrectomy, and propensity to receive an allograft nephrectomy. In conclusion, within a large, nationally representative sample of high-risk patients returning to long-term dialysis after failed kidney transplant, receipt of allograft nephrectomy independently associated with improved survival.

Related Articles

This Month's Highlights
J. Am. Soc. Nephrol. 2010 21: A16. [Full Text] [PDF]

This article has been cited by other articles:

				H. M. Schaefer and J. H. Helderman Allograft Nephrectomy after Transplant Failure: Should It Be Performed in All Patients Returning to Dialysis? J. Am. Soc. Nephrol., February 1, 2010; 21(2): 207 - 208. [Full Text] [PDF]

Copyright © 2009 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673