What happens after graft loss? A large, long‐term, single‐center observation
Summary The number of patients returning to dialysis after graft failure increases. Surprisingly, little is known about the clinical and immunological outcomes of this cohort. We retrospectively analyzed 254 patients after kidney allograft loss between 1997 and 2017 and report clinical outcomes such...
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| Veröffentlicht in: | Transplant international 2021-04, Vol.34 (4), p.732-742 |
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| creator | Schrezenmeier, Eva Lehner, Lukas J. Merkel, Marina Mayrdorfer, Manuel Duettmann, Wiebke Naik, Marcel G. Fröhlich, Felix Liefeldt, Lutz Pigorsch, Mareen Friedersdorff, Frank Schmidt, Danilo Niemann, Matthias Lachmann, Nils Budde, Klemens Halleck, Fabian |
| description | Summary
The number of patients returning to dialysis after graft failure increases. Surprisingly, little is known about the clinical and immunological outcomes of this cohort. We retrospectively analyzed 254 patients after kidney allograft loss between 1997 and 2017 and report clinical outcomes such as mortality, relisting, retransplantations, transplant nephrectomies, and immunization status. Of the 254 patients, 49% had died 5 years after graft loss, while 27% were relisted, 14% were on dialysis and not relisted, and only 11% were retransplanted 5 years after graft loss. In the complete observational period, 111/254 (43.7%) patients were relisted. Of these, 72.1% of patients were under 55 years of age at time of graft loss and only 13.5% of patients were ≥65 years. Age at graft loss was associated with relisting in a logistic regression analysis. In the complete observational period, 42 patients (16.5%) were retransplanted. Only 4 of those (9.5%) were ≥65 years at time of graft loss. Nephrectomy had no impact on survival, relisting, or development of dnDSA. Patients after allograft loss have a high overall mortality. Immunization contributes to long waiting times. Only a very limited number of patients are retransplanted especially when ≥65 years at time of graft loss. |
| doi_str_mv | 10.1111/tri.13834 |
| format | Article |
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The number of patients returning to dialysis after graft failure increases. Surprisingly, little is known about the clinical and immunological outcomes of this cohort. We retrospectively analyzed 254 patients after kidney allograft loss between 1997 and 2017 and report clinical outcomes such as mortality, relisting, retransplantations, transplant nephrectomies, and immunization status. Of the 254 patients, 49% had died 5 years after graft loss, while 27% were relisted, 14% were on dialysis and not relisted, and only 11% were retransplanted 5 years after graft loss. In the complete observational period, 111/254 (43.7%) patients were relisted. Of these, 72.1% of patients were under 55 years of age at time of graft loss and only 13.5% of patients were ≥65 years. Age at graft loss was associated with relisting in a logistic regression analysis. In the complete observational period, 42 patients (16.5%) were retransplanted. Only 4 of those (9.5%) were ≥65 years at time of graft loss. Nephrectomy had no impact on survival, relisting, or development of dnDSA. Patients after allograft loss have a high overall mortality. Immunization contributes to long waiting times. Only a very limited number of patients are retransplanted especially when ≥65 years at time of graft loss.</description><identifier>ISSN: 0934-0874</identifier><identifier>EISSN: 1432-2277</identifier><identifier>DOI: 10.1111/tri.13834</identifier><identifier>PMID: 33527467</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Dialysis ; dnDSA ; graft loss ; Graft rejection ; Grafting ; Grafts ; Immunization ; Immunology ; Kidney transplantation ; Mortality ; Nephrectomy ; PIRCHE score ; Regression analysis ; relisting</subject><ispartof>Transplant international, 2021-04, Vol.34 (4), p.732-742</ispartof><rights>2021 The Authors. published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT</rights><rights>2021 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.</rights><rights>2021. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3884-1e38d4a6786ca5261ef7a8187dcf7e9d5f2e34e4244418b3e57d98706d306fe53</citedby><cites>FETCH-LOGICAL-c3884-1e38d4a6786ca5261ef7a8187dcf7e9d5f2e34e4244418b3e57d98706d306fe53</cites><orcidid>0000-0002-7929-5942 ; 0000-0002-0016-7885 ; 0000-0002-3104-911X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftri.13834$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftri.13834$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33527467$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schrezenmeier, Eva</creatorcontrib><creatorcontrib>Lehner, Lukas J.</creatorcontrib><creatorcontrib>Merkel, Marina</creatorcontrib><creatorcontrib>Mayrdorfer, Manuel</creatorcontrib><creatorcontrib>Duettmann, Wiebke</creatorcontrib><creatorcontrib>Naik, Marcel G.</creatorcontrib><creatorcontrib>Fröhlich, Felix</creatorcontrib><creatorcontrib>Liefeldt, Lutz</creatorcontrib><creatorcontrib>Pigorsch, Mareen</creatorcontrib><creatorcontrib>Friedersdorff, Frank</creatorcontrib><creatorcontrib>Schmidt, Danilo</creatorcontrib><creatorcontrib>Niemann, Matthias</creatorcontrib><creatorcontrib>Lachmann, Nils</creatorcontrib><creatorcontrib>Budde, Klemens</creatorcontrib><creatorcontrib>Halleck, Fabian</creatorcontrib><title>What happens after graft loss? A large, long‐term, single‐center observation</title><title>Transplant international</title><addtitle>Transpl Int</addtitle><description>Summary
The number of patients returning to dialysis after graft failure increases. Surprisingly, little is known about the clinical and immunological outcomes of this cohort. We retrospectively analyzed 254 patients after kidney allograft loss between 1997 and 2017 and report clinical outcomes such as mortality, relisting, retransplantations, transplant nephrectomies, and immunization status. Of the 254 patients, 49% had died 5 years after graft loss, while 27% were relisted, 14% were on dialysis and not relisted, and only 11% were retransplanted 5 years after graft loss. In the complete observational period, 111/254 (43.7%) patients were relisted. Of these, 72.1% of patients were under 55 years of age at time of graft loss and only 13.5% of patients were ≥65 years. Age at graft loss was associated with relisting in a logistic regression analysis. In the complete observational period, 42 patients (16.5%) were retransplanted. Only 4 of those (9.5%) were ≥65 years at time of graft loss. Nephrectomy had no impact on survival, relisting, or development of dnDSA. Patients after allograft loss have a high overall mortality. Immunization contributes to long waiting times. Only a very limited number of patients are retransplanted especially when ≥65 years at time of graft loss.</description><subject>Dialysis</subject><subject>dnDSA</subject><subject>graft loss</subject><subject>Graft rejection</subject><subject>Grafting</subject><subject>Grafts</subject><subject>Immunization</subject><subject>Immunology</subject><subject>Kidney transplantation</subject><subject>Mortality</subject><subject>Nephrectomy</subject><subject>PIRCHE score</subject><subject>Regression analysis</subject><subject>relisting</subject><issn>0934-0874</issn><issn>1432-2277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kNtKw0AQhhdRbD1c-AIS8EbB1D3v5kpK8QQFRSpeLttk0qakSd1Nld75CD6jT-LWVC8E5-ZnmG9-Zn6EjgjukVAXjSt6hGnGt1CXcEZjSpXaRl2cMB5jrXgH7Xk_wxhTLfAu6jAmqOJSddHD89Q20dQuFlD5yOYNuGjigkZl7f1l1I9K6yZwHtpq8vn-Eebz88gX1aSE0KZQrTfqsQf3apuirg7QTm5LD4cb3UdP11ejwW08vL-5G_SHccq05jEBpjNupdIytYJKArmymmiVpbmCJBM5BcaBU8450WMGQmWJVlhmDMscBNtHp63vwtUvS_CNmRc-hbK0FdRLbyjXQhDJuAzoyR90Vi9dFa4zVOCEkkRSFqizlkpd-NxBbhaumFu3MgSbdcwmxGy-Yw7s8cZxOZ5D9kv-5BqAixZ4K0pY_e9kRo93reUXOx2HBg</recordid><startdate>202104</startdate><enddate>202104</enddate><creator>Schrezenmeier, Eva</creator><creator>Lehner, Lukas J.</creator><creator>Merkel, Marina</creator><creator>Mayrdorfer, Manuel</creator><creator>Duettmann, Wiebke</creator><creator>Naik, Marcel G.</creator><creator>Fröhlich, Felix</creator><creator>Liefeldt, Lutz</creator><creator>Pigorsch, Mareen</creator><creator>Friedersdorff, Frank</creator><creator>Schmidt, Danilo</creator><creator>Niemann, Matthias</creator><creator>Lachmann, Nils</creator><creator>Budde, Klemens</creator><creator>Halleck, Fabian</creator><general>Blackwell Publishing Ltd</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7929-5942</orcidid><orcidid>https://orcid.org/0000-0002-0016-7885</orcidid><orcidid>https://orcid.org/0000-0002-3104-911X</orcidid></search><sort><creationdate>202104</creationdate><title>What happens after graft loss? A large, long‐term, single‐center observation</title><author>Schrezenmeier, Eva ; Lehner, Lukas J. ; Merkel, Marina ; Mayrdorfer, Manuel ; Duettmann, Wiebke ; Naik, Marcel G. ; Fröhlich, Felix ; Liefeldt, Lutz ; Pigorsch, Mareen ; Friedersdorff, Frank ; Schmidt, Danilo ; Niemann, Matthias ; Lachmann, Nils ; Budde, Klemens ; Halleck, Fabian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3884-1e38d4a6786ca5261ef7a8187dcf7e9d5f2e34e4244418b3e57d98706d306fe53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Dialysis</topic><topic>dnDSA</topic><topic>graft loss</topic><topic>Graft rejection</topic><topic>Grafting</topic><topic>Grafts</topic><topic>Immunization</topic><topic>Immunology</topic><topic>Kidney transplantation</topic><topic>Mortality</topic><topic>Nephrectomy</topic><topic>PIRCHE score</topic><topic>Regression analysis</topic><topic>relisting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schrezenmeier, Eva</creatorcontrib><creatorcontrib>Lehner, Lukas J.</creatorcontrib><creatorcontrib>Merkel, Marina</creatorcontrib><creatorcontrib>Mayrdorfer, Manuel</creatorcontrib><creatorcontrib>Duettmann, Wiebke</creatorcontrib><creatorcontrib>Naik, Marcel G.</creatorcontrib><creatorcontrib>Fröhlich, Felix</creatorcontrib><creatorcontrib>Liefeldt, Lutz</creatorcontrib><creatorcontrib>Pigorsch, Mareen</creatorcontrib><creatorcontrib>Friedersdorff, Frank</creatorcontrib><creatorcontrib>Schmidt, Danilo</creatorcontrib><creatorcontrib>Niemann, Matthias</creatorcontrib><creatorcontrib>Lachmann, Nils</creatorcontrib><creatorcontrib>Budde, Klemens</creatorcontrib><creatorcontrib>Halleck, Fabian</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplant international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schrezenmeier, Eva</au><au>Lehner, Lukas J.</au><au>Merkel, Marina</au><au>Mayrdorfer, Manuel</au><au>Duettmann, Wiebke</au><au>Naik, Marcel G.</au><au>Fröhlich, Felix</au><au>Liefeldt, Lutz</au><au>Pigorsch, Mareen</au><au>Friedersdorff, Frank</au><au>Schmidt, Danilo</au><au>Niemann, Matthias</au><au>Lachmann, Nils</au><au>Budde, Klemens</au><au>Halleck, Fabian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>What happens after graft loss? A large, long‐term, single‐center observation</atitle><jtitle>Transplant international</jtitle><addtitle>Transpl Int</addtitle><date>2021-04</date><risdate>2021</risdate><volume>34</volume><issue>4</issue><spage>732</spage><epage>742</epage><pages>732-742</pages><issn>0934-0874</issn><eissn>1432-2277</eissn><abstract>Summary
The number of patients returning to dialysis after graft failure increases. Surprisingly, little is known about the clinical and immunological outcomes of this cohort. We retrospectively analyzed 254 patients after kidney allograft loss between 1997 and 2017 and report clinical outcomes such as mortality, relisting, retransplantations, transplant nephrectomies, and immunization status. Of the 254 patients, 49% had died 5 years after graft loss, while 27% were relisted, 14% were on dialysis and not relisted, and only 11% were retransplanted 5 years after graft loss. In the complete observational period, 111/254 (43.7%) patients were relisted. Of these, 72.1% of patients were under 55 years of age at time of graft loss and only 13.5% of patients were ≥65 years. Age at graft loss was associated with relisting in a logistic regression analysis. In the complete observational period, 42 patients (16.5%) were retransplanted. Only 4 of those (9.5%) were ≥65 years at time of graft loss. Nephrectomy had no impact on survival, relisting, or development of dnDSA. Patients after allograft loss have a high overall mortality. Immunization contributes to long waiting times. Only a very limited number of patients are retransplanted especially when ≥65 years at time of graft loss.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>33527467</pmid><doi>10.1111/tri.13834</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-7929-5942</orcidid><orcidid>https://orcid.org/0000-0002-0016-7885</orcidid><orcidid>https://orcid.org/0000-0002-3104-911X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Dialysis dnDSA graft loss Graft rejection Grafting Grafts Immunization Immunology Kidney transplantation Mortality Nephrectomy PIRCHE score Regression analysis relisting |
| title | What happens after graft loss? A large, long‐term, single‐center observation |
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