Pre-dialysis transplant recipients with a high level of kidney function don't benefit from their transplant more than pre-dialysis recipients with low level kidney function, according to a paper being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego, CA. The findings indicate that there may be no urgency for kidney disease patients to get a transplant while their kidneys are still somewhat healthy.
Kidney disease patients with pre-dialysis transplants ("preemptive" transplantation) tend to live longer and have higher functioning transplants than post-dialysis transplant recipients. However, researchers didn't know if higher kidney function among pre-dialysis recipients improves patients' long-term health.
To find out, Basit Javaid, MD (Stanford University School of Medicine), and his colleagues analyzed data from the United Network for Organ Sharing (UNOS) and looked at all preemptive kidney transplant recipients who received their first kidney transplant between October, 1987 and February, 2009. These 25,748 preemptive kidney transplant recipients were divided into two groups: patients with higher kidney function and patients with lower kidney function at the time of transplant.
The investigators found that patient and kidney transplant survival were similar in the two groups. "Based on these findings, we feel that patients and transplant experts anticipating a preemptive kidney transplant can wait for clinical indications to emerge without any significant loss of survival advantage associated with a preemptive transplant," said Dr. Javaid. The researchers did note, however, that patients with higher kidney function needed less dialysis within the first week after transplantation and were less often treated for kidney rejection in the first six months after transplantation.
Study co-authors include Marc Melcher, MD, Jin-Yon Kim, MD, Julie Yabu, MD, Jane Tan, MD, John Scandling, MD, and Stephan Busque, MD (Stanford University School of Medicine).
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