RETRANSPLANTATION IMPROVES SURVIVAL AFTER GRAFT FAILURE: A MULTICENTER COHORT STUDY

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https://storage.unitedwebnetwork.com/files/1099/37c7decb61b34569f701c6489c0f5d5e.pdf

Abstract Title *

RETRANSPLANTATION IMPROVES SURVIVAL AFTER GRAFT FAILURE: A MULTICENTER COHORT STUDY

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Co-author 1

Lina Gomez linapao316@gmail.com Complejo asistencial universitario de León Departamet of Nephrology León Spain *

Co-author 2

Celia Rodriguez crodrigueztu@saludcastillayleon.es Complejo asistencial universitario de Salamanca Departamet of Nephrology Salamanca Spain -

Co-author 3

George Estifan jestefan@saludcastillayleon.es Complejo asistencial universitario de León Departamet of Nephrology León Spain -

Co-author 4

Aranzazu Sastre asastrelo@saludcastillayleon.es Complejo asistencial universitario de León Departamet of Nephrology León Spain -

Co-author 5

Gonzalo Delgado gcdelgado@saludcastillayleon.es Complejo asistencial universitario de Salamanca Departamet of Nephrology Salamanca Spain -

Co-author 6

Maria Rodriguez mrodriguezsar@saludcastillayleon.es Complejo asistencial universitario de León Departamet of Nephrology León Spain -

Co-author 7

Gabriela Bravo mgbravo@saludcastillayleon.es Complejo asistencial universitario de León Departamet of Nephrology Leon Spain -

Co-author 8

Maria Román mromanpe@saludcastillayleon.es Complejo asistencial universitario de León Departamet of Nephrology Leon Spain -

Co-author 9

Cristina Lucas clucasa@saludcastillayleon.es Complejo asistencial universitario de León Departamet of Nephrology Leon Spain -

Co-author 10

Elena Monfá emonfa@saludcastillayleon.es Complejo asistencial universitario de León Departamet of Nephrology Leon Spain -

Co-author 11

Caterine Martinez cvmartinez@saludcastillayleon.es Complejo asistencial universitario de León Departamet of Nephrology Leon Spain -

Co-author 12

Xhamy Martelli xymartelli@saludcastillayleon.es Complejo asistencial universitario de Leon Departamet of Nephrology Leon Spain -

Co-author 13

Guadalupe Tabernero gtabernero@saludcastillayleon.es Complejo asistencial universitario de Salamanca Departamet of Nephrology Salamanca Spain -

Co-author 14

Pilar Fraile mpfraile@saludcastillayleon.es Complejo asistencial universitario de Salamanca Departamet of Nephrology Salamanca Spain -

Co-author 15

Mario Prieto mprietov@saludcastillayleon.es Complejo asistencial universitario de León Departamet of Nephrology León Spain -

Introduction

Loss of the kidney graft often requires return to dialysis, a scenario associated with high morbidity and mortality. Identifying prognostic factors is essential to improve outcomes.

Methods

We conducted a retrospective multicenter study in two Spanish university hospitals, including 91 patients who resumed dialysis after graft failure between January 2017 and June 2025. Clinical and functional variables were collected. Survival was assessed with Kaplan–Meier and Cox proportional hazards models.

Results

Baseline characteristics are summarized in Table 1.

Median survival after dialysis resumption was 27.7 months. Infections were the leading cause of hospitalization (54.9%) and death (57%).

Independent predictors of higher mortality were: - Diabetes mellitus: HR 4.51 (95% CI 1.97–10.30), p < 0.001 - Number of hospitalizations: HR 1.15 per admission (95% CI 1.06–1.24), p = 0.001

Retransplantation emerged as a protective factor (HR 0.56, 95% CI 0.32–0.97, p = 0.040). Table 1 Characteristics of the cohort

Conclusion

In this Spanish multicenter cohort, retransplantation significantly improved survival among kidney transplant recipients returning to dialysis. Anticipated access to retransplantation is essential to maximize this benefit. Conversely, diabetes and frequent hospitalizations were associated with increased mortality, while infections remained the leading cause of death. These findings underscore the need to expand anticipated retransplantation opportunities and to implement intensified infection prevention and management strategies in this high-risk population.

Kewords