Effects of pre-transplant dialysis modality on early outcome of kidney transplantation from donation after cardiac death

Abstract

Objective To compare the influence of hemodialysis (HD) and peritoneal dialysis (PD) on early outcome of patients underwent kidney transplantation from donation after cardiac death (DCD). Methods Patients admitted in the First People's Hospital of Foshan with DCD kidney transplant from January 1st, 2011 to June 30th, 2016 were analyzed retrospectively. Recipients were grouped into HD group (n=61) and PD group (n=28) according to their pre-transplant dialysis modality. Their short-term outcomes after DCD kidney transplant were compared, including recovery of renal function, short-term complications and laboratory data. Results Patients had longer dialysis duration and lower hemoglobin, serum albumin and phosphorus in PD group than those in HD group (all P 0.05). HD patients with 6.00(4.00, 11.00) d recovery time of renal function, 18.00(17.00, 21.50) d hospital time, had 24.59% the delayed graft function (DGF), 3.28% acute rejection and 16.39% infection during hospitalization. While for PD patients the recovery time of renal function was 4.00(3.75, 7.00) d; hospital time was 19.00(15.00, 21.75) d; the incidence rate of DGF was 14.29%; acute rejection was 3.57%; and infection during hospitalization reached 17.86%. Above indexes were not significantly different between HD and PD groups (all P>0.05). Repeated measure ments showed that, compared with those before transplant surgery, after 1 month, 3 months and 6 months HD and PD groups had decreased creatinine and phosphorus, and increased hemoglobinserum albumin and calcium; Serum albumin and calcium were different between the two groups (P<0.001, P=0.040), whereas creatinine, hemoglobin and phosphorus did not show difference (all P<0.05). After transplantation the trends of creatinine, hemoglobin, calcium and phosphorus were not different between the two groups (P values were 0.295, 0.310, 0.501 and 0.063, respectively). Conclusions No significant difference of the recovery regarding renal function, anemia, nutrition status and mineral metabolites was found between pre-transplant HD and PD modality in patients who underwent DCD kidney transplantations. Key words: Renal dialysis; Peritoneal dialysis; Tissue and organ procurement; Kidney transplantation