Evaluation of kidney transplants performed at Akdeniz University Medical Faculty Hospital between 2010-2016

Evaluation of kidney transplants performed at Akdeniz University Medical Faculty Hospital between 2010-2016. Renal transplantation in end stage renal failure patients is the best treatment option that maximizes the patient's life time and the quality of life. Preemptive transplantation can not be performed for all patients because of the inadequate number of donors. The aim of this study was to compare the perioperative effects of dialysis before renal transplantation. In this study 666 patients who underwent kidney transplantation at our center were evaluated retrospectively. Patients were divided into pre-transplant dialysis patients (67.3%, n = 448) and preemptive transplant patients (32.7%, n = 218). Patients were compared preoperatively, intraoperatively and postoperatively. There was no difference in terms of intraoperative blood, blood product, crystalloid, colloid solution requirement, inotropic-vasopressor agent usage and haemodynamic parameters between the pretrasnplant dialysis and preemptively transplanted patients. It was observed that dialysis requirement, delayed graft function and acute rejection development were significantly higher in patients who underwent dialysis before transplantation in postoperative period. In the patients who underwent dialysis in the pre-transplantation period, the first drop of serum creatine levels in the postoperative period was higher than the preemptive ones, but this differences dissappear on the first year follow-up. There was no significant difference in long-term follow-up in terms of serum albumin levels and changes in proteinuria of patients. In terms of patient and graft survival, there were no diffences between pretransplant dialysis patients and preemptive transplant patients on 3 years follow-up. We suggest that it is a treatment that should be considered as the first choice in patients with end-stage renal failure, since patients with preemptive transplantation may have fewer deterioration in metabolic function, lower risk of complication and more successful outcomes in terms of cost-effectiveness ratio.