Clinical outcome of preemptive kidney transplantation in patients with diabetes mellitus.

Son, Y K; Oh, J S; Kim, S M; Jeon, J M; Shin, Y H; Kim, J K
Transplantation proceedings
2010Nov ; 42 ( 9 ) :3497-502.
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Son, Y K -
Oh, J S -
Kim, S M -
Jeon, J M -
Shin, Y H -
Kim, J K -
ABSTRACT
End-stage renal disease (ESRD) caused by diabetic nephropathy is increasing throughout the world. The survival of diabetic patients treated by transplantation has improved nowadays. Although recent studies have demonstrated preemptive kidney transplantation to be associated with better graft survival in CKD patients, the effect of pre-transplantation dialysis on graft outcomes among diabetic ESRD patients is unclear. This analysis summarized our experience with preemptive kidney transplantation in diabetic ESRD patients by retrospectively comparing 70 such patients transplanted between 1995 and 2009. These 70 patients were divided into two groups: 30 patients underwent preemptive and the other 40 transplantation after maintenance hemodialysis or peritoneal dialysis. We compared graft survivals, acute rejection episodes, postoperative complications, and delayed graft function rates. The 10-year patient survival of 100% in the preemptive group was similar to that of the nonpreemptive group (85%, P = .11). But the 10 year graft survival was higher among the preemptive than the nonpreemptive group (100% vs 75%, P = .02). Pre-transplantation modality did not affect graft survival. Therefore, preemptive kidney transplantation should be applied to eligible patients with diabetic ESRD. CI - Copyright ??2010 Elsevier Inc. All rights reserved.
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MESH
Adult, Aged, Delayed Graft Function/etiology, Diabetic Nephropathies/complications/mortality/*surgery, Disease Progression, Female, Graft Rejection/etiology, Graft Survival, Humans, Immunosuppressive Agents/therapeutic use, Kaplan-Meier Estimate, Kidney Failure, Chronic/etiology/mortality/*surgery, *Kidney Transplantation/adverse effects/mortality, Korea, Male, Middle Aged, Patient Selection, Peritoneal Dialysis, Proportional Hazards Models, Renal Dialysis, Retrospective Studies, Risk Assessment, Risk Factors, Survival Rate, Time Factors, Treatment Outcome
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The incidence of delayed graft function (dialysis in the first week after transplantation) was not different among the three groups. Acute rejection episodes occurred in 10% of patients in the preemptive versus 9.1% of the HD and 16.7% of the PD group.
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DOI
10.1016/j.transproceed.2010.09.009
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ICD 03
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