Introduction: transplant nephrectomy (NX) is a known cause of allosensitisation after graft failure. As yet, there is no consensus for the management of the patient with a failed graft returning to dialysis with respect to NX and the potential impact of NX on the likelihood of re-transplantation has not been hitherto investigated.

Methods: patients were divided into two groups according to whether they underwent NX after transplant failure (NX+, n=61) or not (NX-, n=48). Sera were assessed for HLA-A/B/Cw/DR/DQ at the time of NX/transplant failure and after 3, 6, 12 and 24 months using the single antigen Luminex assay. Matchability analysis estimates the relative ease (high score) or difficulty (low score) a patient may have in finding a good HLA matched donor taking into account blood group, HLA type and unacceptable class I and II HLA antigens. Transplant matchability was calculated using the tool provided by the Organ Donation and Transplantation UK.

Results: matchability analysis did not differ at the time of NX/failure and 3 months, although we found a significant difference in the matchability score starting from the 6-month time point (Figure 1), which resulted in a significantly higher prevalence of patients with “difficult” match in the NX+ group compared to NX-, persisting up to 24 months later.

Discussion: NX leads to significant long-term allosensitization and this negatively impacts on the likelihood of receiving a second transplant. NX after allograft failure should only be undertaken if clinically indicated.

CITATION INFORMATION: Lucisano G., Brookes P., Santos-Nunez E., Firmin N., Gunby N., Hassan S., Gueret-Wardle A., Willicombe M., Taube D. The Likelihood of Re-Transplantation in Patients Undergoing Allograft Nephrectomy Am J Transplant. 2017;17 (suppl 3).

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