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Preemptive transplantation and the transplant first initiative.
Curr Opin Nephrol Hypertens. 2010 Nov; 19(6):592-7.CO

Abstract

PURPOSE OF REVIEW

Preemptive kidney transplant (PKT) is the focus of a new initiative, 'Transplant First'. This initiative focuses on increasing patient transition to transplantation prior to the need for dialysis. This review will evaluate the benefits of PKT and means to accomplish this goal.

RECENT FINDINGS

Outcomes data show PKT significantly improves long-term survival for the recipient and the allograft. In addition quality of life is improved. This also holds true for children and particularly for adolescents. In 2008, 5.7% of incident patients with end-stage renal disease were placed on the waiting list before beginning dialysis and 0.8% underwent preemptive living donor transplant before wait listing. If patients are evaluated before starting dialysis and are acceptable candidates, up to 40% will receive a preemptive transplant. Recent articles stress that patients want information from their physician; important impediments to PKT remain provider and patient education, insurance coverage and patient reluctance to ask for living donation.

SUMMARY

Preemptive transplant saves lives. Increased education focused on providers, patients and entire communities is key, as is an increase in living donation. Furthermore, to maximize the impact of transplant first, increased living donor protections and immunosuppression coverage for the life of the allograft are essential.

Authors+Show Affiliations

Division of Nephrology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98195, USA. cdavis@nephrology.washington.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

20827196

Citation

Davis, Connie L.. "Preemptive Transplantation and the Transplant First Initiative." Current Opinion in Nephrology and Hypertension, vol. 19, no. 6, 2010, pp. 592-7.
Davis CL. Preemptive transplantation and the transplant first initiative. Curr Opin Nephrol Hypertens. 2010;19(6):592-7.
Davis, C. L. (2010). Preemptive transplantation and the transplant first initiative. Current Opinion in Nephrology and Hypertension, 19(6), 592-7. https://doi.org/10.1097/MNH.0b013e32833e04f5
Davis CL. Preemptive Transplantation and the Transplant First Initiative. Curr Opin Nephrol Hypertens. 2010;19(6):592-7. PubMed PMID: 20827196.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preemptive transplantation and the transplant first initiative. A1 - Davis,Connie L, PY - 2010/9/10/entrez PY - 2010/9/10/pubmed PY - 2011/2/2/medline SP - 592 EP - 7 JF - Current opinion in nephrology and hypertension JO - Curr Opin Nephrol Hypertens VL - 19 IS - 6 N2 - PURPOSE OF REVIEW: Preemptive kidney transplant (PKT) is the focus of a new initiative, 'Transplant First'. This initiative focuses on increasing patient transition to transplantation prior to the need for dialysis. This review will evaluate the benefits of PKT and means to accomplish this goal. RECENT FINDINGS: Outcomes data show PKT significantly improves long-term survival for the recipient and the allograft. In addition quality of life is improved. This also holds true for children and particularly for adolescents. In 2008, 5.7% of incident patients with end-stage renal disease were placed on the waiting list before beginning dialysis and 0.8% underwent preemptive living donor transplant before wait listing. If patients are evaluated before starting dialysis and are acceptable candidates, up to 40% will receive a preemptive transplant. Recent articles stress that patients want information from their physician; important impediments to PKT remain provider and patient education, insurance coverage and patient reluctance to ask for living donation. SUMMARY: Preemptive transplant saves lives. Increased education focused on providers, patients and entire communities is key, as is an increase in living donation. Furthermore, to maximize the impact of transplant first, increased living donor protections and immunosuppression coverage for the life of the allograft are essential. SN - 1473-6543 UR - https://www.unboundmedicine.com/medline/citation/20827196/Preemptive_transplantation_and_the_transplant_first_initiative_ DB - PRIME DP - Unbound Medicine ER -