Earlier May Not Be Better For Preemptive Transplant

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SAN DIEGO—Pre-dialysis transplant recipients with a high level of kidney function do not appear to benefit from their transplant more than pre-dialysis recipients with a low level of kidney function, data show.

The findings, presented here at the American Society of Nephrology's Renal Week conference, suggest that pre-dialysis patients need not rush to have a preemptive transplant.

Patients who have undergone preemptive transplantation tend to live longer and have higher functioning transplants than post-dialysis transplant recipients. However, studies have not looked whether higher kidney function among pre-dialysis recipients improves patients' long-term health.

Using data from the United Network for Organ Sharing, researchers at Stanford University School of Medicine in Stanford, Calif., identified 25,748 preemptive transplant recipients and divided them into two groups: patients with higher kidney function and patients with lower kidney function at the time of transplant.

Patient and kidney transplant survival were similar in the two groups. The high-level group had a 34% decreased risk of acute rejection at six months post-transplant and a 35% reduced risk of requiring dialysis within the first week after transplantation.

“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 Basit Javaid, MD, Assistant Professor of Medicine at Stanford.

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