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Impact of Prolonged Dialysis Prior to Renal Transplantation.

Impact of Prolonged Dialysis Prior to Renal Transplantation.
Author Information (click to view)

Aufhauser DD, Peng AW, Murken DR, Concors SJ, Abt PL, Sawinski D, Bloom RD, Reese PP, Levine MH,


Aufhauser DD, Peng AW, Murken DR, Concors SJ, Abt PL, Sawinski D, Bloom RD, Reese PP, Levine MH, (click to view)

Aufhauser DD, Peng AW, Murken DR, Concors SJ, Abt PL, Sawinski D, Bloom RD, Reese PP, Levine MH,

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Clinical transplantation 2018 04 15() e13260 doi 10.1111/ctr.13260
Abstract
INTRODUCTION
The new Kidney Allocation System (KAS) prioritizes patients based on date of dialysis initiation or wait-listing, whichever is earlier. We hypothesized that this change would increase transplant rates for patients with prolonged pre-transplant dialysis times (DT) and aimed to assess the impact of prolonged DT on post-transplant outcomes.

METHODS
We used United Network for Organ Sharing registry data to assess outcomes for patients added to the renal transplant waitlist from Jan 1 1998 – Dec 31 2010 and patients transplanted from Jan 1 1998 – Dec 3 2012.

RESULTS
Compared with patients transplanted preemptively, patients with <5 years, 5-9 years, and ≥10 years DT had progressively decreased graft and patient survival (p<0.001). The rates of short-term complications including delayed graft function, graft loss within 30 days, and patient death within 30 days were significantly higher in cohorts with ≥10 years DT than in cohorts with less DT (p<0.001). CONCLUSIONS
Patients with pre-transplant DT of ≥10 years had worse outcomes than patients pre-emptively transplanted or transplanted with shorter DT. Durations of dialysis dependence beyond 10 years were associated with further deterioration in short-term but not long-term post-transplant outcomes. This article is protected by copyright. All rights reserved.

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