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Impact of transplant nephrectomy on peak PRA levels and outcome after kidney re-transplantation.
Tittelbach-Helmrich, Dietlind; Pisarski, Przemyslaw; Offermann, Gerd; Geyer, Marcel; Thomusch, Oliver; Hopt, Ulrich Theodor; Drognitz, Oliver.
Afiliação
  • Tittelbach-Helmrich D; Dietlind Tittelbach-Helmrich, Przemyslaw Pisarski, Oliver Thomusch, Ulrich Theodor Hopt, Oliver Drognitz, Department of General Surgery, University of Freiburg, 79106 Freiburg i. Brsg., Germany.
  • Pisarski P; Dietlind Tittelbach-Helmrich, Przemyslaw Pisarski, Oliver Thomusch, Ulrich Theodor Hopt, Oliver Drognitz, Department of General Surgery, University of Freiburg, 79106 Freiburg i. Brsg., Germany.
  • Offermann G; Dietlind Tittelbach-Helmrich, Przemyslaw Pisarski, Oliver Thomusch, Ulrich Theodor Hopt, Oliver Drognitz, Department of General Surgery, University of Freiburg, 79106 Freiburg i. Brsg., Germany.
  • Geyer M; Dietlind Tittelbach-Helmrich, Przemyslaw Pisarski, Oliver Thomusch, Ulrich Theodor Hopt, Oliver Drognitz, Department of General Surgery, University of Freiburg, 79106 Freiburg i. Brsg., Germany.
  • Thomusch O; Dietlind Tittelbach-Helmrich, Przemyslaw Pisarski, Oliver Thomusch, Ulrich Theodor Hopt, Oliver Drognitz, Department of General Surgery, University of Freiburg, 79106 Freiburg i. Brsg., Germany.
  • Hopt UT; Dietlind Tittelbach-Helmrich, Przemyslaw Pisarski, Oliver Thomusch, Ulrich Theodor Hopt, Oliver Drognitz, Department of General Surgery, University of Freiburg, 79106 Freiburg i. Brsg., Germany.
  • Drognitz O; Dietlind Tittelbach-Helmrich, Przemyslaw Pisarski, Oliver Thomusch, Ulrich Theodor Hopt, Oliver Drognitz, Department of General Surgery, University of Freiburg, 79106 Freiburg i. Brsg., Germany.
World J Transplant ; 4(2): 141-7, 2014 Jun 24.
Article em En | MEDLINE | ID: mdl-25032103
AIM: To determine the impact of transplant nephrectomy on peak panel reactive antibody (PRA) levels, patient and graft survival in kidney re-transplants. METHODS: From 1969 to 2006, a total of 609 kidney re-transplantations were performed at the University of Freiburg and the Campus Benjamin Franklin of the University of Berlin. Patients with PRA levels above (5%) before first kidney transplantation were excluded from further analysis (n = 304). Patients with graft nephrectomy (n = 245, NE+) were retrospectively compared to 60 kidney re-transplants without prior graft nephrectomy (NE-). RESULTS: Peak PRA levels between the first and the second transplantation were higher in patients undergoing graft nephrectomy (P = 0.098), whereas the last PRA levels before the second kidney transplantation did not differ between the groups. Age adjusted survival for the second kidney graft, censored for death with functioning graft, were comparable in both groups. Waiting time between first and second transplantation did not influence the graft survival significantly in the group that underwent nephrectomy. In contrast, patients without nephrectomy experienced better graft survival rates when re-transplantation was performed within one year after graft loss (P = 0.033). Age adjusted patient survival rates at 1 and 5 years were 94.1% and 86.3% vs 83.1% and 75.4% group NE+ and NE-, respectively (P < 0.01). CONCLUSION: Transplant nephrectomy leads to a temporary increase in PRA levels that normalize before kidney re-transplantation. In patients without nephrectomy of a non-viable kidney graft timing of re-transplantation significantly influences graft survival after a second transplantation. Most importantly, transplant nephrectomy is associated with a significantly longer patient survival.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: World J Transplant Ano de publicação: 2014 Tipo de documento: Article País de afiliação: Alemanha País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: World J Transplant Ano de publicação: 2014 Tipo de documento: Article País de afiliação: Alemanha País de publicação: Estados Unidos