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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


  • 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


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.


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.


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).


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.


  • NIDDK Support