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 subsequen t renal function, all 662 consecutive cyclosporine-treated renal trans plants (484 cadaver and 178 living-related donors), performed between 1983 and 1989 were retrospectively analyzed. Recipients were divided i nto 3 groups as follows: group I and II recipients underwent hemodialy sis and peritoneal dialysis, respectively, prior to transplantation; g roup III patients were transplanted without dialysis. All groups were similar with respect to demographic and immunologic characteristics, a part from a higher proportion of diabetic and White patients in both c adaver and living-related group III recipients and a fewer number of b lood transfusions among living-related group III recipients. A trend t oward a decreased incidence of dialysis dependence in the early posttr ansplant period was noted among cadaver donor recipients in group III (20%) when compared to group I and II patients (36% and 26%, respectiv ely). The incidence of rejection episodes was similar in all groups. N o difference in 1- and 5-year patient survival was noted among all rec ipient 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 diff erent (53%, 51%, and 67%, respectively, for cadaver donor; and 75%, 69 %, and 82%, for living-related donor recipients). Renal function, as a ssessed by serum creatinine concentration, was similar and stable in a ll recipient groups. In conclusion, the need for and the mode of dialy sis prior to transplantation had no significant impact on long-term gr aft outcome in cyclosporine-treated patients.