Table 4.

Associations of second kidney transplant (compared with transplant waitlisting) with mortality among patients who experienced failure of a first kidney transplant

Patient SubgroupNo. of Patients WaitlistedReceived TransplantDied without Second TransplantDied after Second TransplantHazard Ratio [95% Confidence Interval) for Death in Transplant RecipientsP Value for Hazard Ratio
All patients waitlisted for second transplant12,021384818585820.36 [0.32 to 0.40]<0.001
Age at time of waitlisting, yr
 18–40372514302941070.29 [0.22 to 0.38]<0.001
 41–606182185210213280.35 [0.31 to 0.41]<0.001
 >6021145665431470.40 [0.32 to 0.49]<0.001
Diabetes-related ESKD17254425571460.34 [0.27 to 0.42]<0.001
Nondiabetes-related ESKD10,296340613014360.37 [0.32 to 0.42]<0.001
Panel reactive antibody
 0%26728724631710.32 [0.26 to 0.40]<0.001
 1%–30%13916162071320.37 [0.28 to 0.49]<0.001
 31%–80%2160761344960.27 [0.20 to 0.35]<0.001
 >80%579615978441830.38 [0.32 to 0.46]<0.001
Kidney Donor Profile Indexa,b
 0%–20%16001012NA1440.32 [0.27 to 0.39]<0.001
 21%–84%43862555NA3660.35 [0.31 to 0.40]<0.001
 85%–100%281234NA550.44 [0.33 to 0.59]<0.001
Duration of first transplant survival
 <3 yr236011573172780.45 [0.37 to 0.55]<0.001
 3–5 yr30209195931410.33 [0.27 to 0.41]<0.001
 >5 yr664117729481630.33 [0.27 to 0.39]<0.001
  • All analyses are adjusted for differences in recipient age, sex, race, cause of ESKD, body mass index, year of waitlisting, insurance type, employment status, congestive heart failure, peripheral vascular disease, cerebrovascular disease, atherosclerotic heart disease, chronic obstructive pulmonary disease, alcohol or drug dependencies, tobacco use, and the inability to ambulate. The reference population in each of these subgroup models is made up of the subgroup’s waitlisted patients that have not yet received (or do not ever receive) a transplant.

  • a For the Kidney Donor Profile Index, transplant recipients are compared with all waitlist patients as waitlisted patients cannot be assigned a Kidney Donor Profile Index value.

  • b Kidney Donor Profile Index could not be determined for 47 transplant patients.