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Orthotopic Rat Kidney Transplantation: A Novel and Simplified Surgical Approach
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Kidney transplantation in patients with long-term (more than 15 years) prior dialysis therapy

T Kimura1, N Ishikawa, T Fujiwara

  • 1Division of Renal Surgery and Transplantation, Department of Urology, Jichi Medical University, Shimotsuke-city, Tochigi, Japan. kimtaka@jichi.ac.jp

Transplantation Proceedings
|February 8, 2012
PubMed

Insights

Kidney transplantation outcomes for long-term hemodialysis patients are similar to short-term patients. This study found comparable patient and graft survival rates, despite some increased perioperative complications in the long-term group.

Area of Science:

  • Nephrology
  • Transplantation Surgery
  • Clinical Outcomes Research

Background:

  • Increasing demand for kidney transplants (KTx) in Japan due to donor shortages.
  • Rising numbers of patients on long-term hemodialysis (HD) undergoing KTx.
  • Need to evaluate KTx outcomes in patients with extended HD duration.

Purpose of the Study:

  • To investigate the outcomes of kidney transplantation in patients on long-term hemodialysis (over 15 years).
  • To compare patient and graft survival rates between long-term and short-term HD patients post-KTx.
  • To analyze complication rates in long-term HD patients following kidney transplantation.

Main Methods:

  • Retrospective analysis of 103 kidney transplantations performed between April 2003 and April 2010.
  • Comparison of seven patients on HD for >15 years (group 1) with 96 patients on HD for <15 years (group 2).
  • Evaluation of patient/graft survivals and complication rates, including acute rejection, infections, and perioperative issues.

Main Results:

  • Similar serum creatinine levels (1.3 mg/dL) at 1 year post-KTx between groups.
  • Patient and graft survival rates were high in both groups: 100%/100% at 1 year and 99%/98% at 3 years for group 2, versus 100%/100% at 1 and 3 years for group 1.
  • Higher incidence of perioperative complications, such as delayed graft function and surgical complications, observed in the long-term HD group (group 1).

Conclusions:

  • Kidney transplantation outcomes for patients on long-term hemodialysis are comparable to those on short-term dialysis.
  • Long-term dialysis patients may experience more perioperative complications, but this does not significantly impact long-term graft or patient survival.
  • KTx remains a viable option for patients requiring extended hemodialysis treatment.
Abstract

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