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Preemptive cadaveric renal transplantation--clinical outcome
J A Roake1, A P Cahill, C M Gray
1Nuffield Department of Surgery, University of Oxford, Churchill Hospital, Headington, United Kingdom.
Transplantation
|November 27, 1996
Summary
Preemptive cadaveric renal transplantation (PCRT) offers better patient and graft survival compared to conventional transplantation. This approach may be safe and clinically justified, but cost and organ utilization require consideration.
Area of Science:
- Nephrology
- Transplantation Immunology
- Public Health
Background:
- Preemptive cadaveric renal transplantation (PCRT) aims to improve quality of life and avoid dialysis morbidity and costs.
- Potential drawbacks include premature organ use, immediate graft failure risk, and safety concerns.
Purpose of the Study:
- To compare patient and graft survival rates between preemptive and non-preemptive cadaveric renal transplantation.
- To assess the safety and clinical outcomes of PCRT.
Main Methods:
- A retrospective analysis comparing 116 PCRT recipients with a matched cohort of dialysis-dependent first cadaveric transplant recipients.
- Matching criteria included sex, age, blood group, HLA match, sensitization, donor age, immunosuppression, and transplantation year.
Main Results:
- PCRT group demonstrated significantly better patient and graft survival.
- Graft survival advantage persisted even after excluding death with a functioning graft.
- No significant differences in graft function (plasma creatinine) were observed between groups.
Conclusions:
- PCRT appears safe and associated with superior graft survival compared to conventional transplantation.
- Early listing for PCRT is clinically justifiable based on outcomes.
- Financial costs and cadaveric kidney utilization are important considerations.