Can preemptive kidney transplantation guarantee longer graft survival in living-donor kidney transplantation? Single-center study.
BACKGROUND
The benefit of preemptive kidney transplantation (KTx) for graft survival compared with nonpreemptive KTx is controversial.


OBJECTIVE
To analyze the influence of preemptive KTx on graft survival.


METHODS
The study included 476 of 531 patients who had undergone living-donor KTx between January 2000 and June 2007. Pediatric patients and those who had previously undergone KTx were excluded. Recipients were divided into 2 groups; group 1 included 413 patients (86.8%) who received grafts after institution of maintenance dialysis, and group 2 included 63 patients (13.2%) who underwent preemptive KTx.


RESULTS
Donor type and HLA mismatch demonstrated significant differences between the 2 groups. Group 1 had more living donors and fewer HLA mismatches. Warm ischemia time in group 2 was significantly shorter than in group 1. The serum creatinine concentration in group 1 on postoperative day 7 was significantly higher than in group 2. Five- and 10-year graft survival in groups 1 and 2, respectively, were 95.3% and 81.3% vs 92.9% and 92.9%. Graft survival was not significant insofar as duration and method of dialysis. At our institution, independent risk factors for graft survival in living-donor KTx are primary end-stage renal disease, acute cellular rejection episodes, and recipient age.


CONCLUSIONS
We observed no benefit on graft survival in recipients of living-donor KTx insofar as whether they had undergone previous dialysis.
Jung
G O
GO
Department of Surgery, Division of Transplantation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Moon
J I
JI
Kim
J M
JM
Choi
G-S
GS
Kwon
C H D
CH
Cho
J-W
JW
Kim
S-J
SJ
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000453:epidemiology; D002648:Child; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival / Q000502:physiology*; D006680:HLA Antigens / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D011183:Postoperative Complications / Q000453:epidemiology; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014777:Virus Diseases / Q000453:epidemiology
D006680:HLA Antigens; D003404:Creatinine