Magee J C, Barr M L, Basadonna G P, Johnson M R, Mahadevan S, McBride M A, Schaubel D E, Leichtman A B
Scientific Registry of Transplant Recipients/University of Michigan, Ann Arbor, Michigan, USA.
Am J Transplant. 2007;7(5 Pt 2):1424-33. doi: 10.1111/j.1600-6143.2007.01786.x.
The prospect of graft loss is a problem faced by all transplant recipients, and retransplantation is often an option when loss occurs. To assess current trends in retransplantation, we analyzed data for retransplant candidates and recipients over the last 10 years, as well as current outcomes. During 2005, retransplant candidates represented 13.5%, 7.9%, 4.1% and 5.5% of all newly registered kidney, liver, heart and lung candidates, respectively. At the end of 2005, candidates for retransplantation accounted for 15.3% of kidney transplant candidates, and lower proportions of liver (5.1%), heart (5.3%) and lung (3.3%) candidates. Retransplants represented 12.4% of kidney, 9.0% of liver, 4.7% of heart and 5.3% of lung transplants performed in 2005. The absolute number of retransplants has grown most notably in kidney transplantation, increasing 40% over the last 10 years; the relative growth of retransplantation was most marked in heart and lung transplantation, increasing 66% and 217%, respectively. The growth of liver retransplantation was only 11%. Unadjusted graft survival remains significantly lower after retransplantation in the most recent cohorts analyzed. Even with careful case mix adjustments, the risk of graft failure following retransplantation is significantly higher than that observed for primary transplants.
移植物丢失的风险是所有移植受者面临的一个问题，当移植物丢失时再次移植通常是一种选择。为了评估再次移植的当前趋势，我们分析了过去10年再次移植候选者和受者的数据以及当前的结果。在2005年期间，再次移植候选者分别占所有新登记的肾、肝、心和肺移植候选者的13.5%、7.9%、4.1%和5.5%。在2005年末，再次移植候选者占肾移植候选者的15.3%，而在肝（5.1%）、心（5.3%）和肺（3.3%）移植候选者中所占比例较低。2005年进行的再次移植占肾移植的12.4%、肝移植的9.0%、心脏移植的4.7%和肺移植的5.3%。再次移植的绝对数量在肾移植中增长最为显著，在过去10年中增加了40%；再次移植的相对增长在心脏和肺移植中最为明显，分别增加了66%和217%。肝再次移植的增长仅为11%。在最近分析的队列中，再次移植后未经调整的移植物存活率仍然显著较低。即使进行了仔细的病例组合调整，再次移植后移植物失败的风险仍显著高于初次移植。
