The Effect of Pretransplantation Dialysis Modality on Long-term Recipient and Graft Survival in Living Donor Kidney Transplantation.
- Author:
Sung Joon SHIN
1
;
Kwon Wook JOO
;
Curie AHN
;
Suhng Gwon KIM
;
Jung Sang LEE
;
Jong Won HA
;
Sang Jun KIM
;
Yon Su KIM
Author Information
1. Department of Internal Medicine, Dongguk University College of Medicine, Korea.
- Publication Type:Original Article
- Keywords:
Preemptive kidney transplantation;
Dialysis;
Survival
- MeSH:
Allografts;
Dialysis*;
Graft Survival*;
Humans;
Kidney Transplantation*;
Kidney*;
Living Donors*;
Peritoneal Dialysis;
Renal Dialysis;
Renal Replacement Therapy;
Retrospective Studies;
Seoul;
Transplants*
- From:Korean Journal of Nephrology
2006;25(3):439-446
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: There is increasing consideration about the preemptive transplantation, transplantation without any preceding dialysis, as a one of options of a renal replacement therapy (RRT). This study evaluates a beneficial effect on recipient and allograft survival of preemptive transplantation and compares the outcome to that according to the dialysis modality and duration. METHODS: All patient who had received a kidney transplant from a living donor in the Seoul National University Hospital (SNUH) between January 1990 and October 2004 are included in this retrospective study. Patients were subdivided into three groups; preemptive transplant group (group 1, n=47), hemodialysis group (group 2, n=307) and peritoneal dialysis group (group 3, n=52). RESULTS: The characteristics of each groups were not statistically different except recipient age. Ten-year patient survival was 97.8% in PE group, but is not significantly higher than in HD (89.4%) and in PD (90.7%) groups. However, 10-year graft survival was higher in PE group than in HD group (p<0.05; 100%, 74.7% respectively). The differential effect of pretransplant dialysis duration on graft survival was prominent if the patients had been on the pretransplant dialysis for more than 42 months (p<0.05; 10-year graft survival; PE, 100% and dialysis more than 42 months, 77.9% respectively) Compared with HD group as a pre-transplant dialysis modality, PD group showed better patient and graft survival rate, but not statistically significant. CONCLUSION: Depending on the above results, we may suggest PE or PD being a superior pre-transplant modality than HD. And we should be considerate of choosing treatment modality and duration before transplantation.
