Preemptive living-donor kidney transplantation: clinical course and outcome

Transplantation. 2004 May 15;77(9):1366-70. doi: 10.1097/01.tp.0000121198.13433.f4.

Abstract

Background: Dialysis is not only associated with morbidity, it is also expensive. In developing countries, preemptive renal transplantation (Tx) may be a cost-effective option, offering an additional benefit to conventional renal Tx.

Materials: Between March 1976 and March 2001, 1,279 first living-donor Txs were performed in our center. The 82 patients (6.4%) who underwent Tx without prior dialysis were compared with 1,197 patients who had been dialyzed before Tx.

Results: The dialysis-dependent group received more blood transfusions (65% vs. 30%) before Tx. Actuarial graft and patient survival at 5 years was comparable in both groups (P =0.2 and P =0.8, respectively). The incidence of acute and chronic rejection was not different between the two groups. Mortality rate was also similar in the two groups. The main cause of death with a functioning graft was cardiovascular in the preemptive Tx group and chronic liver disease and infection in the control group.

Conclusion: In the context of a developing country, preemptive Tx offers comparable patient and graft survival to conventional renal Tx and eliminates the complications, inconvenience, and cost of dialysis.

MeSH terms

  • Adult
  • Cost-Benefit Analysis
  • Developing Countries
  • Egypt / epidemiology
  • Female
  • Graft Survival
  • Humans
  • Kidney Failure, Chronic / economics*
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / economics*
  • Kidney Transplantation / mortality*
  • Living Donors*
  • Male
  • Renal Dialysis / economics
  • Survival Analysis
  • Treatment Outcome