Newswise — Successful kidney transplantation provides a better overall outcome compared to dialysis, and doubles the life expectancy of patients with renal failure, according to a new study, appearing in the June Journal of the American Society of Nephrology (JASN).
Dr. Gabriel C. Oniscu and colleagues of The Royal Infirmary of Edinburgh performed a longitudinal study of 4,532 adult dialysis patients between January 1989 and December 1999 to obtain additional information about the survival benefits for transplant recipients versus dialysis patients in Scotland. Of the patients receiving dialysis, 38 percent were listed for a first cadaveric transplant during this period. The 24 percent of patients who received a transplant during this study had a 54 percent lower mortality rate with a 17.19 year projected life span. Patients remaining on dialysis only had a 5.84 year projected life span.
Additionally, the patients who remained on dialysis had twice the incidence of myocardial infarction and angina, as well as a higher prevalence of smoking and developing gastrointestinal disorders and cerebrovascular diseases.
Although transplant recipients initially face an increased risk of death, this becomes significantly lower during the first year after the transplant, and continues to lessen beyond that timeframe. Ultimately, the long-term risk of mortality is 68 percent less for transplant recipients than dialysis patients.
Success of transplantation is attributed to continuous advances in the field, such as better immunosuppressive medication, organ procurement, patient preparation and surgical technique, which have led to a considerable reduction in long-term risk. Survival of dialysis has also improved over time due to improved therapeutic regimens and patient monitoring.
It is important to note that earlier studies may have failed to identify the survival benefit of transplantation over dialysis by failing to account accurately for the differences between the two treatments.
The study entitled, "Impact of Cadaveric Renal Transplantation on Survival in Patients Listed for Transplantation" is available in the June issue of JASN or online at http://www.asn-online.org or http://www.jasn.org.
The ASN is a not-for-profit organization of 9,000 physicians and scientists dedicated to the study of nephrology and committed to providing a forum for the promulgation of information regarding the latest research and clinical findings on kidney diseases.
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Journal of the American Society of Nephrology (Jun-2005)