Hernández, DomingoMuriel, AlfonsoCastro de la Nuez, PabloAlonso-Titos, JuanaRuiz-Esteban, PedroDuarte, AnaGonzalez-Molina, MiguelPalma, EulaliaAlonso, ManuelTorres, Armando2023-01-252023-01-252018-03-07http://hdl.handle.net/10668/12217Whether patients waitlisted for a second transplant after failure of a previous kidney graft have higher mortality than transplant-näive waitlisted patients is uncertain. We assessed the relationship between a failed transplant and mortality in 3851 adult KT candidates, listed between 1984-2012, using a competing risk analysis in the total population and in a propensity score-matched cohort. Mortality was also modeled by inverse probability weighting (IPTW) competing risk regression. At waitlist entry 225 (5.8%) patients had experienced transplant failure. All-cause mortality was higher in the post-graft failure group (16% vs. 11%; P = 0.033). Most deaths occurred within three years after listing. Cardiovascular disease was the leading cause of death (25.3%), followed by infections (19.3%). Multivariate competing risk regression showed that prior transplant failure was associated with a 1.5-fold increased risk of mortality (95% confidence interval [CI], 1.01-2.2). After propensity score matching (1:5), the competing risk regression model revealed a subhazard ratio (SHR) of 1.6 (95% CI, 1.01-2.5). A similar mortality risk was observed after the IPTW analysis (SHR, 1.7; 95% CI, 1.1-2.6). Previous transplant failure is associated with increased mortality among KT candidates after relisting. This information is important in daily clinical practice when assessing relisted patients for a retransplant.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/AdultCardiovascular DiseasesCause of DeathCohort StudiesEuropeGraft SurvivalHumansKidney TransplantationPropensity ScoreRegistriesRisk AssessmentRisk FactorsSurvival AnalysisSurvival RateTreatment FailureWaiting Listsresearch article29513701open access10.1371/journal.pone.01930911932-6203PMC5841738https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0193091&type=printablehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5841738/pdf