So Your Transplanted Kidney is Failing, Now What?

You were lucky enough to receive a kidney transplant years ago, but now it is failing. Is it better to opt for another transplant or go on dialysis?

New research suggests a second transplant may be the better option.

Kidney transplants from deceased donors function for a median of 10 to 15 years, which means many don't last for the rest of the recipient's life. It has been unclear whether it's best to get another kidney transplant or be treated with dialysis at that point. However, Blacks tend to have to wait a longer time for kidney transplants than whites.

What the study shows

To learn more, researchers analyzed data from more than 2,300 adults in Austria whose first transplanted kidney failed and they were put on a waiting list for a second kidney transplant.

Over a 10-year follow-up, patients who received a second kidney transplant lived an average of 5.8 months longer than those who underwent dialysis while remaining on the transplant waiting list.

However, the difference in survival time among re-transplantation patients was slightly lower in those who waited longer for their second kidney transplant.

Compared to those in the dialysis group, re-transplantation patients who received a new kidney within a year lived an average of eight months longer, while those who received a new kidney within eight years lived an average of 0.1 months longer.

The study was published Dec. 27 in the Clinical Journal of the American Society of Nephrology.

"Our data showed that a second transplantation is advantageous regarding gained life years; however, the difference to non-transplanted patients decreases with time on the waiting list," study leader Dr. Rainer Oberbauer, from the Medical University of Vienna in Austria says.

"Nevertheless, patients might have a higher quality of life when transplanted and therefore should get a second transplant if a suitable donor organ is available," he said in a journal news release.

Patients with a failed first kidney transplant should be placed on a waiting list immediately if they are fit to undergo a second transplantation, Oberbauer emphasizes.

If "these results are reproduced in imitated trials from other countries, it would signify the importance of decreasing time on the waiting list for second kidney transplant candidates by measures such as expedited work-up and enlistment of patients with failing first kidney transplants before they require dialysis," an accompanying editorial notes.

Tips while waiting on a kidney transplant

If you are currently on the waitlist for a kidney transplant, the American Kidney Fund suggests the following:

Do not miss appointments with your transplant team, primary doctor, and other doctors.
If you are on dialysis, do not miss your dialysis sessions.
Let your transplant team know if you experience any changes in your health, even if you feel like you just caught a cold.
Take all medicines prescribed to you by your transplant team. Let the transplant team know if you are taking medicine from another doctor.
Carefully follow the eating and exercise plan given to you by the transplant team. You may be asked to see a dietitian or physical therapist.
Manage your health care by keeping all of your medical papers in a folder or binder so they are all available in one place.
If you are a woman, talk to your transplant team about birth control, and what you should know about having children before and after your transplant.
Immediately let your transplant team know if any part of your contact information changes, especially your address or phone number.