Lin J, et al. - Researchers sought to investigate the upshot of allograft nephrectomy (AN) and no-AN (No AN) on the outcome of renal retransplantation. Based on the yielded data it was suggested that the failed graft was to be allowed to remain unless symptoms indicated the need for surgery. With the intention of improving the long-term outcome of retransplantation, donor-specific antibody dynamic monitoring and better human leukocyte antigen matching was recommended.

Methods

• Using the MEDLINE, Embase and the Cochrane Library data, a systematic review and meta-analysis were carried out.
• Experts included observational studies or randomized controlled trials encompassing renal retransplantation recipients with AN or No-AN.
• Graft survival, patient survival, acute rejection (AR) and delayed graft dysfunction served as the primary outcomes.
• The secondary outcomes consisted of positive panel reactive antibody rate and serum creatinine level at 1 year after retransplantation, cold ischemia time and time of hemodialysis before recent transplantation.
• An estimation was conducted of the pooled estimates of odds ratios (ORs) and the weighted mean difference for outcomes.

Results

• This analysis constituted 13 studies divided into 20 trials including 1,923 subjects.
• A substantially higher 3-year graft survival rate {OR 0.48 [95% confidence interval (CI) 0.34-0.69], 10 studies, n = 1,030} and 5-year graft survival rate [OR 0.65 (95% CI 0.44-0.97), 16 studies, n = 1,878] were reported in the No-AN group than the AN group.
• Data illustrated markedly higher rates of 5-year patient survival [OR 1.82 (95% CI 1.14-2.90), 5 studies, n = 749], positive panel reactive antibody [OR 3.08 (95% CI 2.08-4.56), 12 studies, n = 1,225], AR [OR 1.59 (95% CI 1.21-2.09), 15 studies, n = 1,388] and delayed graft dysfunction [OR 1.66 (95% CI 1.20-2.03), 8 studies, n = 879] in the AN group.
• In contrast with the No-AN group, longer cold ischemia time was discovered in the AN group [weighted mean difference 1.84 (95% CI 0.90-2.79), 7 studies, n = 919].
• Findings unveiled similar rate of 1-year graft survival and 10-year graft survival, serum creatinine levels at 1 year after retransplantation and the time of hemodialysis before recent transplantation between the AN and No-AN groups.