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21 May 2009

Adult pre-emptive kidney transplantation: a paired kidney analysis

T Debska-Slizien, B Bzoma, G Moszkowska, I Skora, A Chamienia, D Zadrozny, Z Sledzinski, B Rutkowski

Ann Transplant 2009; 14(1): 24-25 :: ID: 880287

Abstract

Background: The present study compares the outcome of 43 adults transplanted without prior dialysis i.e. pre-emptive transplantation (PET) and their kidney pairs transplanted after variable duration of dialysis i.e.pre-transplantation dialysis (PTD). We investigated the potential advantages of PET.
Material/Methods: In the period from November'2003 to December'2008, 43 patients (30M, 13F) received PET (4 living/39 cadaver donors). 36/43 PET patients (24M, 22F) - mean age 40.4±13.9 years had their PTD kidney pair (26M, 10F) - mean age 44.6±13 years. PTD patients remained on dialysis for 3.5 to 180 (mean 38) months before transplantation.
Results: Mean waiting time for transplantation was 3.3 vs. 23 months (p<0.05)  and the mean Charlson co-morbidity index was 2.4 vs. 2.8 in PET and PTD group (NS). Studied groups (PET vs. PTD) did not differ significantly with respect to: number of mismatches, one year patient (97.2% vs. 97.2%) and graft survival (88.9% vs. 88.9%), one-year death censored graft survival (91.7% vs. 91.7%) and the incidences of acute rejection (28% vs. 33%). 4 (11%) PET and 10 (28%) PTD patients experienced delayed graft function (p<0.05). Estimated GFR (MDRD and C-G) during one year after transplantation was similar in both groups but the comparison of the creatinine concentration revealed that it was significantly lower in PET group and stable during observation. (p<0.05). More PTD patients had professional activity before and after transplantation (p<0.05).
Conclusions: Our single-centre results confirm that PET is an optimal mode of
renal replacement therapy for both medical and socioeconomic reasons.

Keywords: Kidney Transplantation

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358