Patients Returning to Dialysis after Failed Kidney Transplant: How Do They Fare? A Gulf Perspective

Samra Abouchacra, Ahmed Chaaban, Abdelkarim Saleh, Muna Rukhaimi, Osman Furaih, Naveed Haq, Mohamed Osman, Nicole Gebran, Qutaiba Hussain, Fares Chedid, Mohammad Budruddin, Suad Sajwani

Department of Nephrology, Dubai Hospital, Dubai, UAE.
Department of Nephrology, King Faisal Specialist Hospital and Research Center, Riyadh, KSA.
Department of Nephrology, Sheikh Khalifa Medical City, Abu Dhabi, UAE.
Department of Nephrology, Tawam Hospital, Al Ain, UAE.

DOI: 10.4236/ojim.2014.43013                

Abstract

An increasing number of failed transplant patients returning to dialysis (FTRD) have been observed with reported worse survival compared to transplant-naive dialysis (TxN) patients. This study aimed to assess outcomes of FTRD vs. matched TxN controls in a Gulf region multi-center trial of 800 HD patients. Similar mortality was seen, likely due to earlier start and better HD adequacy in FTRD. Younger age, less diabetes and living donor transplantation in majority with 27% graft nephrectomy (Nx) might also confer benefits. Subgroup analysis of Nx patients showed more hospitalizations and prior rejection episodes with lower graft survival. The deaths, however, oc-curred only in nonNx group and are likely explained by older age, longer duration on HD, more prevalence of diabetes and CAD. FTRD showed similar survival to TxN. Early intensive HD might account for the benefit. Whether Nx confers advantage is unclear because of the small sample size.

Keywords

Renal Transplant, Graft Nephrectomy, Hemodialysis Dialysis, Transplant-Naive Patients, End Stage Renal Disease, ESRD

Conflicts of Interest

The authors declare no conflicts of interest.

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