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  • Title: Can preemptive kidney transplantation guarantee longer graft survival in living-donor kidney transplantation? Single-center study.
    Author: Jung GO, Moon JI, Kim JM, Choi GS, Kwon CH, Cho JW, Kim SJ.
    Journal: Transplant Proc; 2010 Apr; 42(3):766-74. PubMed ID: 20430167.
    Abstract:
    INTRODUCTION: 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. PATIENTS AND 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. CONCLUSION: We observed no benefit on graft survival in recipients of living-donor KTx insofar as whether they had undergone previous dialysis.
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