Influence of Dialysis Duration on the Outcome of Living Kidney Transplantation

Abstract

Previous studies have reported negative impacts of long-term dialysis on kidney transplantation (KTx) outcomes. However, advances in surgical techniques, immunosuppressive therapies, and post-transplant monitoring have led to an impressive increase in patient and allograft survival. Thus, the number of KTx among patients on long-term dialysis is increasing. We evaluated the influence of dialysis duration on the outcome of living donor KTx. Between January 2000 and October 2011, we performed 1098 first KTx from living donors in adults (>18 years). We divided the patients into six groups, A group: pre-emptive kidney transplantation, B group: <24 months duration of dialysis, C group: 25-60 months duration, D group: 61-120 months duration, E group: 121-240 months duration, and F group: ≥ 241 months duration. The 5-year patient survival rates were 95.7, 98.8, 99.0, 99.0, 97.3, and 100% in groups A-F, respectively. The 5-year graft survival rates were 91.3, 95.6, 94.2, 96.3, 90.7, and 100% in groups A-F, respectively. No significant differences were observed in patient or graft survival among the six groups. Longer dialysis duration was correlated with lower rates of preoperative hypertension and diabetes mellitus. Survivors of long-term dialysis tended to be in good compliance with self-management. If recipients of living KTx have few complications, good prognoses are expectable even if dialysis periods are very long.

Comparison of intraoperative hemodynamic parameters of recipients in adult living donor and deceased donor kidney transplantations

“…Therefore, pretransplant duration of dialysis also varies between countries. While some studies reported that longterm dialysis negatively affects the results of KT, others showed that there is no difference in terms of graft or patient survival with the length of dialysis treatment (3,4). Studies from the USA have shown that KT performed after a long dialysis period was associated with a higher risk of graft failure and death compared to preemptive KT (5).…”

Influence of dialysis duration on outcomes of simultaneous pancreas‐kidney transplant

“…This study included 6887 patients who were divided into four groups based on the duration of dialysis: preemptive SPK or PSPK (group A), 0‐2 years of dialysis (group B), 2‐5 years of dialysis (group C), and >5 years of dialysis (group D). Long‐term dialysis was defined as 2‐5 years or >5 years of dialysis 8 . The duration of dialysis was calculated as the transplant date minus the date on which dialysis was started.…”

“…Additionally, Helantera and his colleagues demonstrated that long‐term preoperative dialysis duration was associated with reduced patient survival, but not reduced graft survival after renal transplantation 11 . In contrast, Kohei et al 8 reported that no significant difference was observed in patient or graft survival for groups with different pre‐transplant dialysis durations. However, there are only a few reports on the impact of pre‐transplant dialysis duration on SPK transplant outcomes in T1DM patients 12,13 .…”

“…Previous studies have defined long‐term dialysis in renal transplantation as 2 to 5 years of dialysis treatment 8 . Long‐term pre‐transplant dialysis duration has been shown to negatively affect kidney transplant outcomes.…”

“…7 Previous studies have defined long-term dialysis in renal transplantation as 2 to 5 years of dialysis treatment. 8 Long-term pretransplant dialysis duration has been shown to negatively affect kidney transplant outcomes. Previous studies have reported that long-term dialysis was associated with increased risk of death and graft failure after kidney transplantation.…”