Preemptive transplantation (PTX) utilizes transplantation as the primary renal replacement therapy in the absence of any preceding dialysis.
In developing countries, PTX may be a cost-effective option, offering additional benefits to conventional transplantation.
Between 1989 and 1996,43 patients who underwent live-related PTX were compared with 86 matched controls who underwent transplantation after hemodialysis.
Pre-and posttransplant morbidity, and graft and patient survival rates were compared.
Median follow-up was 15 months in the preemptive group and 20.5 months in the control group.
Controls received more transfusions (4.6±2.6 vs. 2.4±2.3), had higher hepatitis B surface antigen positivity [12 (14.6%) vs. 1 (2.4%) ], and more commonly had hepatic dysfunction [5 (5.8%) vs. nil) ] in the pretransplant period compared with the preemptive group.
Similarly, at 6 months after transplant, the incidence of hepatitis B surface antigen positivity (13 vs. 2) and hepatic dysfunction (18 vs. 3) were higher in the control group compared with the preemptive group.
The 1-and 2-year graft (preemptive : 82.8% and 77.3% ; controls : 82% and 78%, respectively) and patient (preemptive : 92% and 89.5% ; controls : 91% and 89.5%, respectively) survival rates were similar.
PTX offers comparable patient and graft survival to conventional transplantation.
It eliminates the complications and inconvenience of dialysis. (...)
Mots-clés Pascal : Homotransplantation, Rein, Homme, Précoce, Pronostic, Economie santé, Transplantation, Chirurgie
Mots-clés Pascal anglais : Homotransplantation, Kidney, Human, Early, Prognosis, Health economy, Transplantation, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0397804
Code Inist : 002B25H. Création : 25/01/1999.