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https://hdl.handle.net/2440/54028
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Type: | Journal article |
Title: | Pre-emptive renal transplantation from living donors in Australia: Effect on allograft and patient survival |
Author: | Milton, C. Russ, G. McDonald, S. |
Citation: | Nephrology, 2008; 13(6):535-540 |
Publisher: | Blackwell Publishing Asia |
Issue Date: | 2008 |
ISSN: | 1320-5358 1440-1797 |
Statement of Responsibility: | Caroline A Milton, Graeme R Russ and Stephen P McDonald |
Abstract: | Aim: Pre-emptive renal transplantation has become the preferred first-line therapy for patients with end-stage kidney failure. This study examines the outcome of allograft and patient survival in pre-emptive transplantation compared with non-pre-emptive transplantation from living donors in Australia and New Zealand. Methods: We have performed a retrospective study using the Australian and New Zealand Dialysis and Transplantation Registry. Allograft and patient survival were compared at 1, 5 and 10 years in pre-emptive transplantation and non-pre-emptive transplantation following a living donor transplant. Results: Allograft survival at 1, 5 and 10 years post pre-emptive transplantation was better than post non-pre-emptive transplantation (multivariate hazard ratio (HR) 0.80 [95% confidence interval 0.64–0.99], P = 0.036). Pre-emptive transplantation was associated with a significant patient survival advantage over non-pre-emptive transplantation when analysed from the time of transplantation and adjusted for age and gender (multivariate HR 0.46 [0.27–0.80], P = 0.006). Patient survival for pre-emptive transplantation and non-pre-emptive transplantation was 97% [0.95–0.98] and 93% [0.91–0.94] at 5 years and 93% [0.88–0.96] and 84% [0.82–0.87] at 10 years post transplant respectively. There was no difference in the overall rejection rate between pre-emptive transplantation and non-pre-emptive transplantation. Vascular rejection was less common in pre-emptive transplantation (HR 0.70 [0.50–0.98], P = 0.04). Conclusion: Pre-emptive transplantation from a living donor is associated with both better allograft and patient survival compared with transplantation after a period of dialysis. Pre-emptive transplantation should be the preferred modality of renal replacement therapy in patients who have a living donor. |
Keywords: | living donor rejection renal transplantation |
DOI: | 10.1111/j.1440-1797.2008.01011.x |
Published version: | http://dx.doi.org/10.1111/j.1440-1797.2008.01011.x |
Appears in Collections: | Aurora harvest Medicine publications |
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