Effect of waiting time on renal transplant outcome

Meier‐Kriesche, Herwig‐Ulf; Port, Friedrich K.; Ojo, Akinlolu; Rudich, Steven M.; Hanson, Julie A.; Cibrik, Diane M.; Leichtman, Alan B.; Kaplan, Bruce

doi:10.1046/j.1523-1755.2000.00287.x

Cited by 587 publications

(403 citation statements)

References 27 publications

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“…However, after adjusting for donor and recipient demographic differences in a multivariate analysis, we found that only the age of the recipient and donor remained as significant factors that affected graft and patient survival rates (7). The recipient race, prior failed transplants, the time spent waiting on dialysis, the cold ischemia time, the retransplant rate, and HLA mismatch, all of which are known to affect the outcome of cadaver kidney transplants in general (8)(9)(10)(11) had no significant effect on graft and patient survival rates among diabetic patients included in this study. Although the incidence of rejection treatment before discharge was higher among SPK (15% versus 9%) than CRT recipients, the difference may be due in part to the longer hospitalization noted for SPK recipients.…”

Section: Discussionmentioning

confidence: 98%

Kidney Allograft and Patient Survival in Type I Diabetic Recipients of Cadaveric Kidney Alone Versus Simultaneous Pancreas/Kidney Transplants

Bunnapradist

Cho²,

Cecka³

et al. 2003

Journal of the American Society of Nephrology

104

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Abstract. Simultaneous pancreas-kidney transplant (SPK) is now a common treatment for insulin-dependent diabetic patients with end-stage renal disease. Renal graft survival rates after SPK have been less well studied. This study compared the kidney survival results for 3642 SPK and 2374 cadaveric renal transplants (CRT) in type I diabetic patients at 112 US transplant centers reported to UNOS during 1994 through 1997. The analysis included follow-up information through September 2000. The kidney graft survival rates were significantly lower among recipients of CRT compared with SPK recipients (P Ͻ 0.001). Patients who received SPK were younger, less often sensitized, transplanted after shorter periods on dialysis, and less often black. The donors of SPK organs were younger, more often died from head trauma, were less often female, and more often black. SPK renal grafts were transplanted with a shorter cold ischemia time to more poorly HLA-matched recipients. After adjustment of these and other factors, whether a patient was recipient of CRT or SPK was not associated with increased risk of kidney graft failure or patient death. SPK recipients experienced half the rate of delayed kidney function (11% versus 23%) but nearly double the rate of rejections during the initial hospitalization (15% versus 9%) compared with CRT recipients. SPK was associated with better renal allograft survival compared with CRT, despite a higher rate of renal allograft rejection. This observation was explained by favorable donor and recipient factors in the SPK group. After controlling for these factors, SPK provided no protective or detrimental effect on short-term renal allograft or patient survival. bunnapradist@cshs.org

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Section: Discussionmentioning

confidence: 98%

Kidney Allograft and Patient Survival in Type I Diabetic Recipients of Cadaveric Kidney Alone Versus Simultaneous Pancreas/Kidney Transplants

Bunnapradist

Cho²,

Cecka³

et al. 2003

Journal of the American Society of Nephrology

104

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“…Furthermore, prolonged dialysis before transplant appears to have a detrimental effect on post-transplant outcomes (17)(18)(19). Goldfarb-Rumyantzev et al (17) found a 25% to 46% increase in graft failure for those transplanted after 6 mo to 5 yr of end stage kidney disease and 32% greater risk of death overall for those transplanted after 3 yr of end stage kidney disease.…”

Section: Discussionmentioning

confidence: 99%

Health Literacy and Access to Kidney Transplantation

Grubbs

Gregorich

Pérez‐Stable

et al. 2009

Clinical Journal of the American Society of Nephrology

165

149

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Background and objectives: Few studies have examined health literacy in patients with end stage kidney disease. We hypothesized that inadequate health literacy in a hemodialysis population is common and is associated with poorer access to kidney transplant wait-lists.Design, setting, participants, & measurements: We enrolled 62 Black and White maintenance hemodialysis patients aged 18 to 75. We measured health literacy using the short form Test of Functional Health Literacy in Adults. Our primary outcomes were (1) time from dialysis start date to referral date for kidney transplant evaluation and (2) time from referral date to date placed on kidney transplant wait-list. We used Cox proportional hazard models to examine the association between health literacy (adequate versus inadequate) and our outcomes after controlling for demographics and co-morbid conditions.Results Conclusions: Inadequate health literacy is common in our hemodialysis patient population and is associated with a lower hazard of referral for transplant evaluation. Strategies to reduce the impact of health literacy on the kidney transplant process should be explored.

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“…Despite many remarkable advances during the past three decades, with transplantation now viewed unequivocally as offering the best survival and quality of life for candidates across all demographic groups, current practice remains that described by Rennie (2). Notwithstanding strong evidence that transplantation is most successful when implemented before onset of long-term dialysis, only 2.5% of patients with end-stage renal disease undergo transplantation as initial RRT (3)(4)(5).…”

mentioning

confidence: 99%

Kidney Transplantation as Primary Therapy for End-Stage Renal Disease

Abecassis

Bartlett

Collins

et al. 2008

Clinical Journal of the American Society of Nephrology

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516

338

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Results: Participants explored the benefits of early transplantation on costs and outcomes, identified current barriers (at multiple levels) that impede access to early transplantation, and recommended specific interventions to overcome those barriers.Conclusions: With implementation of early education, referral to a transplant center coincident with creation of vascular access, timely transplant evaluation, and identification of potential living donors, early transplantation can be an option for substantially more patients with chronic kidney disease.

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Effect of waiting time on renal transplant outcome

Cited by 587 publications

References 27 publications

Kidney Allograft and Patient Survival in Type I Diabetic Recipients of Cadaveric Kidney Alone Versus Simultaneous Pancreas/Kidney Transplants

Kidney Allograft and Patient Survival in Type I Diabetic Recipients of Cadaveric Kidney Alone Versus Simultaneous Pancreas/Kidney Transplants

Health Literacy and Access to Kidney Transplantation

Kidney Transplantation as Primary Therapy for End-Stage Renal Disease

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