[Better before than after?].
Kidney transplantation before dialysis, or preemptive transplantation, is an optimal therapeutic strategy for end-stage renal disease and offers clinical advantages compared to post-dialysis transplant. Graft and patient survival rates have been shown to be comparable or even better for preemptive transplantation in different studies, avoiding the morbidities and cost of dialysis treatment. Nevertheless, it is not a realistic opportunity for the majority of patients and in our country it is performed only in living-donor, pediatric or combined kidney-pancreas transplantation. Right now, the length of the waiting list and the waiting times for cadaver donor kidneys are the most serious issues and call for ethical reflections. In transplantation, the individual medical advantage and social benefit should always converge.
Boschiero
Luigi
L
Centro Trapianti Renali, Azienda Ospedaliero-Universitaria, Verona, Italy. centro.trapianti.renali@azosp.vr.it
D006801:Humans; D016030:Kidney Transplantation; D011322:Primary Prevention; D006435:Renal Dialysis; D013997:Time Factors