Journal
CLINICAL TRANSPLANTATION
Volume 24, Issue 2, Pages 243-251Publisher
WILEY
DOI: 10.1111/j.1399-0012.2009.01055.x
Keywords
kidney transplantation; retransplant; sirolimus
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Objective: We sought to examine repeat versus primary renal transplantations using sirolimus-based regimens. Methods: We compared 98 repeat versus 200 matched primary recipients treated de novo with sirolimus plus cyclosporine. Every repeat case received polyclonal antibody induction and continuous steroids. Outcomes were evaluated over a mean five-year follow-up by univariate and multivariate techniques. Kaplan-Meier plots were analyzed with using log-rank statistics with significance at P < 0.05. Results: Significant differences in demographic features included greater panel reactive antibody (PRA), younger age, fewer HLA-mismatches and more pre-emptive repeat versus primary grafts. Neither graft and patient survivals, nor incidences of biopsy-proven acute rejection (BPAR), chronic vasculopathy or tubular atrophy/interstitial fibrosis among biopsies performed for cause were significantly different at 1 and 5 years. Younger recipients, better HLA matches and absence of diabetes promoted repeat graft survival; whereas older age, longer cold ischemia time and BPAR reduced primary transplant outcomes. Renal function was similar at 1, 3, 12, 24, 48 and 60 months. Conclusion: At 5 years this sirolimus regimen achieved similar efficacy for repeat versus primary transplantations.
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