Renal transplantation after failure of a first graft.

Renal transplantation in the nondiabetic patient can be achieved with a graft survival comparable with the over-all survival of the cadaveric first graft. The utilization of immunologic donor pretreatment in second cadaveric renal transplantation was of no benefit to graft survival. The second graft survived significantly longer than the first graft when the survival in the same patients was evaluated in a paired fashion. In our experience, retransplantation in the patient with juvenile-onset diabetes using a cadaveric graft gives disastrous results. Of pretreatment, splenectomy, transfusion, preformed antibodies, antigens mismatched, course and time of first-graft loss, diabetes, age and donor source analyzed in this study, only diabetes was found to have a significant effect upon the survival of the second graft.