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CAPD and renal transplantation.

P K Donnelly, B K Shenton, T W Lennard

    The British Journal of Surgery
    |October 1, 1985
    PubMed
    Summary
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    Continuous ambulatory peritoneal dialysis (CAPD) does not increase the risk of kidney transplant rejection. This study found similar patient and graft survival rates between CAPD and haemodialysis (HD) patients, recommending CAPD use.

    Area of Science:

    • Nephrology
    • Immunology
    • Transplantation

    Background:

    • Continuous ambulatory peritoneal dialysis (CAPD) is thought to enhance immune function in end-stage renal failure patients.
    • Concerns exist that CAPD may elevate the risk of graft rejection after kidney transplantation.

    Purpose of the Study:

    • To evaluate the impact of CAPD versus haemodialysis (HD) on renal transplant outcomes.
    • To determine if CAPD poses an immunological risk factor for kidney transplantation.

    Main Methods:

    • A retrospective study of 220 consecutive renal transplants in patients treated with CAPD or HD.
    • Comparative analysis of patient and graft survival, including matched-pair analysis for specific patient characteristics.
    • In vitro studies of lymphocyte function and plasma suppressive activity.

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    Main Results:

    • No significant difference in patient and graft survival between CAPD and HD groups over five years.
    • One-year graft survival (excluding non-immunological failures) was comparable: 77% for CAPD vs. 79% for HD in first cadaver recipients.
    • In a matched-pair analysis, one-year graft survival was higher for CAPD patients (82%) than HD patients (61%).
    • In vitro studies showed no differences in immune function between CAPD and HD patients.

    Conclusions:

    • Continuous ambulatory peritoneal dialysis is not an immunological risk factor in renal transplantation.
    • CAPD can be safely used in patients awaiting kidney transplantation.
    • The study recommends the continued use of CAPD for patients preparing for renal transplantation.