Does Long-Term Dialysis Therapy Affect the Results of Kidney Transplantation?

Abstract

Introduction and aims: Since the donor shortage, dialysis patients need to wait a long time for kidney transplantation in Japan. The proportion of patients with long-term (more than 10 years) dialysis therapy has reached to about 25% of all dialysis patients. Accordingly, the number of kidney transplantation in patients on long-term haemodialysis (HD) has been increasing. We investigated the outcomes of kidney transplantation among patients on long-term (more than 10 years) HD. Methods: We performed 112 cases of living donor kidney transplantation between April 2003 and March 2011. All patients received quadruple sequential immunosuppression, such as tacrolimus or cyclosporine, mycophenolate mofetil, methylprednisolone, and basiliximab. Ten patients were treated with HD for more than 10 years (G1) and 102 patients were treated with HD less than 10 years (G2) before transplantation. We compared the difference in the patient and graft survival and complications, such as cytomegalovirus antigenemia, acute rejection, and surgical complications between the groups. Results: The mean HD period was 165.4±71.3 months in G1 and 25.4±26.5 months in G2. The patient/graft survival (death censored) were 100%/100% at 1 year and 80%/100% at 3 year in G1, 100%/100% at 1 year and 99%/99% at 3 year in G2. The incidence of cytomegalovirus antigenemia was 70% in G1 and 43% in G2, respectively. Acute rejection occurred in 2 (20%) of G1 and 28 (27%) of G2. Surgical complications were observed in 1 (10%) of G1 and 9 (9%) of G2. The serum creatinine at 1 year after renal transplantation was 1.3 mg/dl in both groups. Conclusions: The outcomes of kidney transplantation in long-term dialysis patients were the same as those in short-term dialysis patients. Renal transplantation could be performed in long-term dialysis patients with high success rate.