2008 Annual Meeting Abstracts
Early Graft Function in Pre-emptive Versus Previously Dialyzed Live Donor Kidney Transplant Recipients
Anthony Del Signore, PharmD1, Paul Morrissey, MD1, Staci Fischer, MD2, Reginald Gohh, MD3, Jason Machan, PhD4, Anthony Monaco, MD1, Angelito Yango, MD3, Carolyn Young, MD5, Kevin P. Charpentier, MD1.
1Division of Transplantation, Department of Surgery, Rhode Island Hospital, Providence, RI, USA, 2Division of Transplantation- Infectious Disease, Rhode Island Hospital, Providence, RI, USA, 3Division of Transplantation- Nephrology, Rhode Island Hospital, Providence, RI, USA, 4Department of Research, Rhode Island Hospital, Providence, RI, USA, 5Rhode Island Blood Center, Providence, RI, USA.
Objective: To assess whether early allograft function differs between pre-emptive (PKT) and previously dialyzed (DKT) live donor kidney transplant recipients.
Design: Retrospective case series
Setting: Division of Transplantation in an academic, tertiary care medical center
Patients: 24 PKT patients were selected and matched with 22 DKT patients based on age and gender, from live donor kidney transplants performed between December 2003 - December 2006. Three PKT and five DKT patients were excluded from the study due to delayed graft function, age < 18, simultaneous pancreas/kidney transplant, and absence of age/gender matched controls.
Main Outcome Measures: The primary outcome was the rate of serum creatinine decline (delta creatinine) throughout the first week post-transplant. Secondary endpoints included creatinine at 1-year post-transplant, patient survival and renal allograft survival.
Results: There was a statistically significant difference in the pre-transplant creatinine between the PKT and DKT groups (6.14 mg/dl vs. 9.72 mg/dl, respectively, P < 0.0001). No other significant difference was observed between the donors or recipients from the 2 groups. The delta creatinine was similar between the two groups with most patients achieving a new baseline serum creatinine by post-transplant day 4. There is no difference in 1-year patient survival (90% PKT vs. 94% DKT, P= 0.6789), serum creatinine at 1 year (1.67 PKT vs. 1.34 DKT, P= 0.3727) or death censored 1-year graft survival (100% both groups).
Conclusions: Delta creatinine appears similar between pre-emptive and previously dialyzed live donor kidney transplant recipients throughout the first week post-transplantation. Creatinine at 1-year, 1-year patient survival and renal allograft survival are similar between the 2 groups.