title: Comparison of Preemptive Kidney Transplantation With Nonpreemptive Kidney Transplantation in a Single Center: A Follow-up Study.
abstract: OBJECTIVE
  The effect of preemptive transplantation of kidneys from living donors on patient and allograft survival is controversial. In this study, we aimed to evaluate whether preemptive kidney transplantation performed without the development of patient dialysis-related complications has a favorable effect on patient and graft survival.
  
  
  METHODS
  The study included 334 adult renal transplant recipients. Patients who underwent renal transplantation between January 2008 and December 2012 at a tertiary referral teaching hospital were followed, and outcomes were obtained by retrospective chart review. A total of 244 patients underwent dialysis before renal transplantation, whereas 90 patients underwent preemptive transplantation.
  
  
  RESULTS
  There were no significant differences between the 2 groups with regard to patients and graft survival rates (P > .05). Patient survival rates in preemptive and nonpreemptive groups were 98.9% and 96.3% in the first year, respectively (P = .199). Graft survival rates in preemptive and nonpreemptive groups were 96.7% and 93.0% in the first year, respectively (P = .163). Patient survival rates in preemptive and nonpreemptive groups were 98.9% and 95.7% in the third year, respectively (P = .155). Graft survival rates in preemptive and nonpreemptive groups were 93.5% and 88.5% in the third year, respectively (P = .138). There was a significant difference among years with regard to ratio of patients with preemptive transplantation (P = .009). The ratio was 17.5% in 2008, whereas it rose to 43.1% in 2012.
  
  
  CONCLUSIONS
  Although preemptive kidney transplantation does not provide a significant patient and allograft survival advantage compared to nonpreemptive kidney transplantation, both therapeutic modalities provide good outcomes. Preemptive kidney transplantation has been an increasingly frequent renal replacement therapy option in recent years.
authors.affiliation: Department of General Surgery, Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey. Electronic address: mustafagokhanunsal@yahoo.com.
authors.forename: M G
authors.initials: MG
authors.lastname: Unsal
authors.affiliation: Department of Nephrology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Yilmaz
authors.affiliation: Department of General Surgery, Ege University School of Medicine, Izmir, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Sezer
authors.affiliation: Department of Nephrology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Celtik
authors.affiliation: Department of General Surgery, Ege University School of Medicine, Izmir, Turkey.
authors.forename: O V
authors.initials: OV
authors.lastname: Unalp
authors.affiliation: Department of General Surgery, Ege University School of Medicine, Izmir, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Uguz
authors.affiliation: Department of General Surgery, Manisa State Hospital, Manisa, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Alci
authors.affiliation: Department of Nephrology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: A F
authors.initials: AF
authors.lastname: Tamer
authors.affiliation: Department of General Surgery, Ege University School of Medicine, Izmir, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Hoscoskun
authors.affiliation: Department of Nephrology, Ege University School of Medicine, Izmir, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Toz
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000401:mortality*; D019520:Living Donors; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D066027:Transplant Recipients / Q000706:statistics & numerical data*; D014184:Transplantation, Homologous; D014421:Turkey / Q000453:epidemiology