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dc.contributor.authorA. Ingsathiten_US
dc.contributor.authorS. Kantachuvesirien_US
dc.contributor.authorS. Rattanasirien_US
dc.contributor.authorY. Avihingsanonen_US
dc.contributor.authorN. Premasathianen_US
dc.contributor.authorC. Pongskulen_US
dc.contributor.authorS. Jittikanonten_US
dc.contributor.authorA. Lumpaopongen_US
dc.contributor.authorV. Sumethkulen_US
dc.date.accessioned2018-09-04T09:33:54Z-
dc.date.available2018-09-04T09:33:54Z-
dc.date.issued2013-05-01en_US
dc.identifier.issn18732623en_US
dc.identifier.issn00411345en_US
dc.identifier.other2-s2.0-84878541030en_US
dc.identifier.other10.1016/j.transproceed.2012.08.029en_US
dc.identifier.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84878541030&origin=inwarden_US
dc.identifier.urihttp://cmuir.cmu.ac.th/jspui/handle/6653943832/52875-
dc.description.abstractIntroduction: Kidney retransplantation is a high-risk procedure that is increasingly performed because of previous graft failure. The aim of this study was to determine the long-term outcomes of kidney retransplantations compared with first kidney transplantations under the current era of immunosuppression. Methods: Since the first retransplantation in Thailand was performed in 1993, this study included all consecutive cases registered in the Thai Transplantation Registry database from January 1993 to December 2011. A total of 3337 kidney transplantations were available for the analysis. Graft loss was defined as a return to dialysis or graft removal. Death with a functioning graft was censored. Results: Of 3337 kidney transplantations during the study period, 113 were second and 3 were third transplantations. Among these 116 retransplantations, the most common identified causes of end-stage renal disease were chronic glomerulonephritis (38.8%), followed by hypertensive nephropathy (13.0%), diabetic nephropathy (6.0%), and lupus nephritis (1.7%). The retransplantation recipients were older (mean age, 46.2 ± 12.8 years) than the first transplantation group (mean age, 42.2 ± 12.8 years). The proportion of living-related kidney transplantations and male sex were similar between first and retransplantation recipients. Fourteen percent of retransplantation recipients showed high immunologic risk as defined by current panel reactive antibodies ≥30% compared with 3% of those in the first transplantation group (P <.001). The percentages of induction therapy with antithymocyte globulin and anti-interleukin-2 antibody in the retransplantation and first transplantation groups were 18.3% versus 4.3% and 60.0% versus 32.6%, respectively. The graft survival rates (95% confidence interval [CI]) at 1, 5, and 10 years were 88.6% (80.7-93.3), 87.3% (79.1-92.5), and 74.4% (53.7-86.9) among retransplantation, versus 95.0% (94.1-95.7), 87.0% (85.5-88.5), and 70.7% (67.4-73.8) among first transplantation groups, respectively (P =.63). Patient survival rates were not different between first and retransplantation groups (P =.42). The leading cause of graft loss in the retransplantation group was chronic allograft nephropathy (22%), whereas infection (57%) was the major cause of death in this group. Conclusion: The 10-year patient and graft survival rates of kidney retransplantation were acceptable. The combination of induction therapy with a calcineurin inhibitor and a mycophenolate mofetil/mychophenolic acid-based regimen lead to outcomes comparable to first kidney transplantations among our cohort of 3337 patients. © 2013 Elsevier Inc. All rights reserved.en_US
dc.subjectMedicineen_US
dc.titleLong-term outcome of kidney retransplantation in comparison with first kidney transplantation: A report from the thai transplantation registryen_US
dc.typeJournalen_US
article.title.sourcetitleTransplantation Proceedingsen_US
article.volume45en_US
article.stream.affiliationsFaculty of Medicine, Ramathibodi Hospital, Mahidol Universityen_US
article.stream.affiliationsKing Chulalongkorn Memorial Hospital, Faculty of Medicine Chulalongkorn Universityen_US
article.stream.affiliationsMahidol Universityen_US
article.stream.affiliationsKhon Kaen Universityen_US
article.stream.affiliationsChiang Mai Universityen_US
article.stream.affiliationsPhramongkutklao College of Medicineen_US
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