Influence of Dialysis Duration on the Outcome of Living Kidney Transplantation

Previous studies have reported negative impacts of long-term dialysis on kidney transplantation (KTx) outcomes. However, advances in surgical techniques, immunosuppressive therapies, and post-transplant monitoring have led to an impressive increase in patient and allograft survival. Thus, the number of KTx among patients on long-term dialysis is increasing. We evaluated the influence of dialysis duration on the outcome of living donor KTx. Between January 2000 and October 2011, we performed 1098 first KTx from living donors in adults (>18 years). We divided the patients into six groups, A group: pre-emptive kidney transplantation, B group: <24 months duration of dialysis, C group: 25-60 months duration, D group: 61-120 months duration, E group: 121-240 months duration, and F group: 241 months duration. The 5-year patient survival rates were 95.7, 98.8, 99.0, 99.0, 97.3, and 100% in groups A-F, respectively. The 5-year graft survival rates were 91.3, 95.6, 94.2, 96.3, 90.7, and 100% in groups A-F, respectively. No significant differences were observed in patient or graft survival among the six groups. Longer dialysis duration was correlated with lower rates of preoperative hypertension and diabetes mellitus. Survivors of long-term dialysis tended to be in good compliance with self-management. If recipients of living KTx have few complications, good prognoses are expectable even if dialysis periods are very long.