ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO2056

The Survival Benefit of Re-Kidney Transplantation in Older and Younger Patients with Graft Failure

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Ahn, JiYoon B., Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Sandal, Shaifali, McGill University Health Centre, Montreal, Quebec, Canada
  • Segev, Dorry L., Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • McAdams-DeMarco, Mara, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

Group or Team Name

  • ERGOT
Background

The survival benefit of re-kidney transplantation (re-KT) has been demonstrated two decades ago in younger patients. The proportion of patients with graft failure is increasing, particularly among those aged≥65. We compared the survival benefit of re-KT by patient age.

Methods

Using data from the Scientific Registry of Transplant Recipients, we identified 42,366 patients who experienced graft failure after their first KT and were listed for re-KT between 1990-2019. We treated re-KT as a time-dependent variable and used Cox regression to compare the risk of mortality between being listed for a re-KT and undergoing re-KT. We used the inverse probability weighting method to account for potential confounding. We also tested whether the risk of mortality differed by patient age at listing (18-64 versus ≥65 years) using a Wald test.

Results

Overall, 42,366 patients were listed for re-KT and 47.5% underwent re-KT by 10/31/2020. The number of patients being listed for re-KT tripled between 1990 and 2019. The mortality rate was 6.6 per 100 person-years among patients being listed and 3.0 per 100 person-years among those retransplanted. Overall, the risk of mortality was lower after re-KT than during listing (adjusted hazard ratio [aHR]=0.420.430.45). However, the association differed by age (Pinteraction=0.03), but the survival benefit of retransplant was observed among both younger (aHR=0.410.420.44) and older patients (aHR=0.430.490.55).

Conclusion

Our finding suggests that re-KT is associated with a significant survival benefit in younger and older patients. In addition, long-term outcomes in older re-KT recipients were reported comparable to those in older first KT recipients. Transplant centers should consider expanding re-KT to appropriate older adults.

Funding

  • NIDDK Support