THE INFLUENCE OF MODE OF DIALYSIS PRETRANSPLANTATION ON LONG-TERM RENAL-ALLOGRAFT OUTCOME

To determine the influence of the need and the mode of dialysis prior to transplantation on long-term renal allograft survival and subsequent renal function, all 662 consecutive cyclosporine-treated renal transplants (484 cadaver and 178 living-related donors), performed between 1983 and 1989 were retrospectively analyzed. Recipients were divided into 3 groups as follows: group I and II recipients underwent hemodialysis and peritoneal dialysis, respectively, prior to transplantation; group III patients were transplanted without dialysis. All groups were similar with respect to demographic and immunologic characteristics, apart from a higher proportion of diabetic and White patients in both cadaver and living-related group III recipients and a fewer number of blood transfusions among living-related group III recipients. A trend toward a decreased incidence of dialysis dependence in the early posttransplant period was noted among cadaver donor recipients in group III (20%) when compared to group I and II patients (36% and 26%, respectively). The incidence of rejection episodes was similar in all groups. No difference in 1- and 5-year patient survival was noted among all recipient groups. Actual 1-year graft survivals in groups I, II, and III were similar (73%, 72%, and 74%, respectively, for cadaver donor; and 86%, 89%, and 91%, respectively for living-related donor recipients). Likewise, actuarial 5-year graft survivals were not significantly different (53%, 51%, and 67%, respectively, for cadaver donor; and 75%, 69%, and 82%, for living-related donor recipients). Renal function, as assessed by serum creatinine concentration, was similar and stable in all recipient groups. In conclusion, the need for and the mode of dialysis prior to transplantation had no significant impact on long-term graft outcome in cyclosporine-treated patients.