Early Kidney Transplant May Be Advantageous

A preemptive transplant may be beneficialfor some patients with diabetes-relatedkidney disease, according to the findings ofa study reported in the Annals of InternalMedicine (January 6, 2006). The researchersnoted that the results indicate that thetechnique is successful when used beforethe need for chronic dialysis.

In their study, the investigators analyzedUS national data on >23,000 patients withtype 1 and type 2 diabetes. The participantshad received kidney transplants from livingor deceased donors or simultaneous pancreas-kidney transplantation. In total, preemptivetransplantations were seen in14.4% of patients with type 1 diabetes and6.7% of patients with type 2 diabetes.

The researchers found—after consideringage, sex, and race—that the techniquewas associated with a lower occurrenceof dying in both types of diabetesonly when the transplant was from a livingdonor. In simultaneous pancreas-kidney transplants, the benefit wasobserved only in patients with type 1 diabetes.The investigators concluded thatthe reduced benefit from preemptivetransplantation from deceased donors,compared with reports in the early1990s, needs further investigation.