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https://hdl.handle.net/2440/76158
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Type: | Journal article |
Title: | Association between initial and pretransplant dialysis modality and graft and patient outcomes in live- and deceased-donor renal transplant recipients |
Author: | Lim, W. Clayton, P. Wong, G. Dogra, G. Budgeon, C. Murray, K. Campbell, S. Cohney, S. Russ, G. Polkinghorne, K. Chadban, S. McDonald, S. |
Citation: | Transplant International, 2012; 25(10):1032-1040 |
Publisher: | Springer-Verlag |
Issue Date: | 2012 |
ISSN: | 0934-0874 1432-2277 |
Statement of Responsibility: | Wai H. Lim, Philip Clayton, Germaine Wong, Gursharan Dogra, Charley A. Budgeon, Kevin Murray, Scott B. Campbell, Solomon Cohney, Graeme R. Russ, Kevan R. Polkinghorne, Steve J. Chadban and Stephen P. McDonald |
Abstract: | The association between pretransplant dialysis modality and transplant outcomes remains inconsistent. The aim of this study is to address the association between alteration in dialysis modality and post-transplant outcomes. Using Australia and New Zealand Dialysis and Transplant Registry, primary live- and deceased-donor renal transplant recipients (RTR) between 1997 and 2009 were examined. Pre-emptive and multiple-organ transplants were excluded. The association between initial and pretransplant dialysis modality and transplant outcomes were examined. Of the 6701 RTR, 18.6% were initiated-maintained on peritoneal dialysis pretransplant (PD-PD), 9.2% were initiated on PD, but maintained on haemodialysis (HD) pretransplant (PD-HD), 63.3% were HD-HD and 8.9% were HD-PD. PD-HD [odds ratio(OR)1.44, 95% CI 1.21,1.72] and HD-HD (OR1.25, 95% CI 1.12,1.41) were associated with a significantly greater risk of slow graft function compared with the overall mean of the groups, whereas a change in initial dialysis modality from HD to pretransplant PD was associated with higher risk of overall graft failure [hazard ratio(HR)1.19, 95% CI 1.04,1.36) and recipient death (HR1.34, 95% CI 1.13,1.59). Our registry analysis suggest that dialysis modality pretransplant may affect transplant outcomes and future studies evaluating patient selection, choice of modality and/or potential interventions in the pre and post-transplant period may have a beneficial effect on post-transplant outcomes. |
Keywords: | ANZDATA dialysis modality haemodialysis kidney transplant peritoneal dialysis registry |
Rights: | © 2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation |
DOI: | 10.1111/j.1432-2277.2012.01528.x |
Published version: | http://dx.doi.org/10.1111/j.1432-2277.2012.01528.x |
Appears in Collections: | Aurora harvest Public Health publications |
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