For patients with a failed first kidney transplant, a second transplant results in longer average survival time, but the advantage decreases with time spent on the waiting list, according to a study published in the Clinical Journal of the American Society of Nephrology. Rainer Oberbauer, PhD, and colleagues conducted a retrospective study using data from 2,346 patients with a failed first graft to examine the association between time on the waiting list and patient survival among those receiving a second transplant versus remaining on the waiting list. The difference in restricted mean survival time (RMST) and hazard ratios for all-cause mortality were compared for “retransplant” and “remain wait-listed with maintenance dialysis” for different waiting times after the first graft loss. RMST at 10 years of follow-up was longer with a second kidney transplantation versus remaining on the waiting list (5.8 life-months gained). In patients with longer waiting time after loss of the first allograft, this survival difference was attenuated: RMST differences at 10 years were 8.0 and 0.1 life-months gained with waiting times for re-transplantation of less than 1 year and 8 years, respectively.
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