When Should Renal Allografts be Removed?

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Abstract
Most patients who receive a cadaver renal transplant have not been offered a kidney from a related, potential donor and are, for a variety of reasons, unsuitable candidates for chronic hemodialysis. The paucity of suitable donors limits the number of transplants that can be performed, and requires some recipients to wait as long as two years before a suitable donor becomes available. Furthermore, to decrease the risk of failure, it has become customary to perform transplants only when no circulating cytotoxic antibodies against the prospective donor exist in the recipient,1 and when the histocompatibility locus A (HL-A) match between donor and recipient is C or better, using the nomenclature of Terasaki.1,2 Despite these precautions complications have developed in the transplant or in the recipient. Under such circumstances removal of the transplant in anticipation of a second or third transplant at a later date must be considered. If there

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