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Paper Information

Title: 

IS PREEMPTIVE RENAL TRANSPLANTATION PREFERRED?

Type: PAPER
Author(s): SIMFOROOSH N.*,POURREZA GHOLI F.,BASSIRI A.,EINOLLAHI B.,FIROUZAN A.,NOURBALA M.H.,HAJARIZADEH B.,MOGHADAM F.,POURFARZIANI V.,LESSAN PEZECHKI M.,LESANPEZESHKI M.,NAFAR M.,KHATAMI M.R.,FARHANGI S.
 
 *
 
Name of Seminar: CONGREH ANJOMAN UROLOGY IRAN
Type of Seminar:  CONGRESS
Sponsor:  ANJOMAN OROLOGY
Date:  2005Volume 8
 
 
Abstract: 

BACKGROUND: TO COMPARE THE RESULTS OF PREEMPTIVE KIDNEY TRANSPLANTATIONS WITH PATIENTS WHO WERE ON CHRONIC DIALYSIS BEFORE TRANSPLANTATION, THIS HISTORICAL COHORT STUDY WAS CONDUCTED.
METHODS & MATERIALS: FROM 1984 TO 2002, 3010 LIVING KIDNEY TRANSPLANRATIONS WERE PERFORMED IN OUR TWO CENTERS. SIMCE 1992, 127 PREEMPTIVE KIDNEY TRANSPLANTATIONS (STUDY GROUP) WERE PERFORMED WHICH WAS COMPARED WITH 186 PATIENTS WHO WERE ON CHRONIC DIALYSIS BEFORE TRANSPLANTATION (CONTROL GROUP) AND UNDERWENT TRANSPLANTATION AT THE SAME TIME. ALL PATIENTS IN CONTROL GROUP HAVE BEEN UNDER DIALYSIS MORE THAN 6 MONTHS. SURVIVAL ANALYSIS WAS PERFORMED APPLYING KAPLAN-MEIER METHOD AND COMPARED IN TWO GROUPS APPLYING LOG RANK METHOD.
RESULTS: THE DIFFERENCE BETWEEN TWO GROUPS WERE NOT SIGNIFICANT AS FAR AS RECIPIENT AGE, SEX, ETIOLOGY OF CRF, DONOR AGE AND SEX, DONIR-RECIPIENT RELATIONSHIP AND IMMUNOSUPPRESSIVE PROTOCOLS, WERE CONCERNED. DIFFERENCE BETWEEN STUDY AND CONTROL GROUP WAS NOT SIGNIFICANT WHEN REJECTION EPISODES WERE STUDIED WHILE THE NEED FOR ALG THERAPYIN STUDY GROUP WAS LESS AND THE RESPONSE TO STEROIDTHERAPY WAS ALSO BETTER IN THIS GROUP COMPARING TO CONTROL GROUP (P=0.002). ONE YEAR, 2 YEARS AND 3 YEARS PATIENT SURVIVAL WERE SIMILAR IN STUDY GROUP WHICH WAS 96.4%, 96.4%, 96.4% ACCORDINGLY COMPARING TO CONTROL GROUP WHICH WAS 97.81%, 96.23% AND 96.23%. ONE YEAR, 2 YEARS AND 3 YEARS GRAFT SURVIVAL WAS BETTER IN STUDY GROUP (PREEMPTIVE TRANSPLANTATION GROUP) WHICH WAS 93.7%, 85.4%, 84.8% ACCORDINGLY COMPARING TO CONTROL GROUP (PATIENTS ON CHRONIC DIALYSIS BEFORE TRANSPLANTATION) WHICH WERE 85.4%, 79.5%. THE DIFFERENCES BETWEEN GROUPS WERE SIGNIFICANT FOR FIRST AND SECOND YEAR (P=0.03 AND 0.02 RESPECTIVELY) WHILE IN THIRD YEAR WAS NOT SIGNIFICANT (P=0.06), BUT THE GRAFT SURVIVAL WAS STILL BETTER IN STUDY GROUP FOR THIRD YEAR FOLLOW UP.
CINCLUSION: GRAFT SURVIVAL IN PREEMPTIVE KIDNEY TRANSPLSNTATION WAS BETTER WHEN COMPARED TO PATIENTS WHO WERE ON CHRONIC RENAL FAILURE WITH ITS POSSIBLE KNOWN ADVERSE EFFECTS. THEREFORE, WE RECOMMEND PREEMPTIVE KIDNEY TRANSPLANTATION AS A BETTER CHOICE FOR PATIENTS WITH CHRONIC RENAL FAIURE WHEN IT IS POSSIBLE.

 
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