A new study found that early preemptive kidney transplants do not reduce the risk of death, according to a study by the Yale School of Medicine (YSM). Porting Procedure March 25th.
End-stage renal disease (ESKD), also known as renal failure or renal failure, can occur due to diabetes and hypertension. Patients with renal failure will need implantation when, or possibly before, dialysis begins. Dialysis stresses the body and weakens the immune system, so it is commonly thought that people with ESKD will have better results if they receive preemptive kidney transplants after undergoing dialysis.
The study, led by MBBS's Abhishek Kumar, is a YSM Associate Professor of Medicine (nephropathy) and medical director of Yale's Living Kidney Donor Program, has examined records over two decades, assessing the current status of preemptive kidney transplants in the United States, and examining records focusing on mortality. Kumar and his colleagues were interested in finding out whether there would be any benefit in performing a later transplant from both the deceased and the livelihood.
“If we receive an organ from a deceased donor list, we have no control over when we get an organ,” Kumar says. “On the other hand, if you have a live donor and have better control over timing, the question is when it's most beneficial to get a port.”
Our research shows that waiting until you really need a transplant is what you should get it. Otherwise, you're losing that time with your kidneys.
Abhishek Kumar, MBBS
This finding does not differ in the results of higher estimated glomerular filtration rate (EGFR), measures of renal function, or mortality in those who received early kidney transplants when EGFR worsened. So, according to Kumar, patients should wait if they have options. “It's all about timing,” Kumar says. “Our research shows that waiting until you really need a transplant means you should get it, otherwise you're losing that time with your own kidneys.
“Telling a patient when it's best to have a transplant is the day that requires dialysis,” he adds.
Dialysis exposures of up to six months will not adversely affect long-term outcomes if transplants occur within that period, Kumar says.
However, the optimal time for dialysis and transplantation is individually dependent and difficult to predict, and says that the transition from chronic kidney disease care to dialysis is expensive and resource-intensive. “Dialysis should always be avoided if possible, but early transplantation is not the solution.”
Nephrology is one of the 10 sections of Yale Medical School. Committed to excellence in patient care, research and education, the faculty and trainees in this section aim to be national and international leaders of academic nephrology. For more information, please see Nephrology.
