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Preemptive living donor kidney transplantation: Access, fate, and review of the status in Egypt

BACKGROUND: Preemptive living donor kidney transplantation (PLDKT) is recommended as the optimal treatment for end-stage renal disease. AIM: To assess the rate of PLDKT among patients who accessed KT in our center and review the status of PLDKT in Egypt. METHODS: We performed a retrospective review...

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Autores principales: Gadelkareem, Rabea Ahmed, Abdelgawad, Amr Mostafa, Reda, Ahmed, Azoz, Nashwa Mostafa, Zarzour, Mohammed Ali, Mohammed, Nasreldin, Hammouda, Hisham Mokhtar, Khalil, Mahmoud
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10354566/
https://www.ncbi.nlm.nih.gov/pubmed/37476008
http://dx.doi.org/10.5527/wjn.v12.i3.40
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author Gadelkareem, Rabea Ahmed
Abdelgawad, Amr Mostafa
Reda, Ahmed
Azoz, Nashwa Mostafa
Zarzour, Mohammed Ali
Mohammed, Nasreldin
Hammouda, Hisham Mokhtar
Khalil, Mahmoud
author_facet Gadelkareem, Rabea Ahmed
Abdelgawad, Amr Mostafa
Reda, Ahmed
Azoz, Nashwa Mostafa
Zarzour, Mohammed Ali
Mohammed, Nasreldin
Hammouda, Hisham Mokhtar
Khalil, Mahmoud
author_sort Gadelkareem, Rabea Ahmed
collection PubMed
description BACKGROUND: Preemptive living donor kidney transplantation (PLDKT) is recommended as the optimal treatment for end-stage renal disease. AIM: To assess the rate of PLDKT among patients who accessed KT in our center and review the status of PLDKT in Egypt. METHODS: We performed a retrospective review of the patients who accessed KT in our center from November 2015 to November 2022. In addition, the PLDKT status in Egypt was reviewed relative to the literature. RESULTS: Of the 304 patients who accessed KT, 32 patients (10.5%) had preemptive access to KT (PAKT). The means of age and estimated glomerular filtration rate were 31.7 ± 13 years and 12.8 ± 3.5 mL/min/1.73 m(2), respectively. Fifty-nine patients had KT, including 3 PLDKTs only (5.1% of total KTs and 9.4% of PAKT). Twenty-nine patients (90.6%) failed to receive PLDKT due to donor unavailability (25%), exclusion (28.6%), regression from donation (3.6%), and patient regression on starting dialysis (39.3%). In multivariate analysis, known primary kidney disease (P = 0.002), patient age (P = 0.031) and sex (P = 0.001) were independent predictors of achievement of KT in our center. However, PAKT was not significantly (P = 0.065) associated with the achievement of KT. Review of the literature revealed lower rates of PLDKT in Egypt than those in the literature. CONCLUSION: Patient age, sex, and primary kidney disease are independent predictors of achieving living donor KT. Despite its non-significant effect, PAKT may enhance the low rates of PLDKT. The main causes of non-achievement of PLDKT were patient regression on starting regular dialysis and donor unavailability or exclusion.
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spelling pubmed-103545662023-07-20 Preemptive living donor kidney transplantation: Access, fate, and review of the status in Egypt Gadelkareem, Rabea Ahmed Abdelgawad, Amr Mostafa Reda, Ahmed Azoz, Nashwa Mostafa Zarzour, Mohammed Ali Mohammed, Nasreldin Hammouda, Hisham Mokhtar Khalil, Mahmoud World J Nephrol Retrospective Cohort Study BACKGROUND: Preemptive living donor kidney transplantation (PLDKT) is recommended as the optimal treatment for end-stage renal disease. AIM: To assess the rate of PLDKT among patients who accessed KT in our center and review the status of PLDKT in Egypt. METHODS: We performed a retrospective review of the patients who accessed KT in our center from November 2015 to November 2022. In addition, the PLDKT status in Egypt was reviewed relative to the literature. RESULTS: Of the 304 patients who accessed KT, 32 patients (10.5%) had preemptive access to KT (PAKT). The means of age and estimated glomerular filtration rate were 31.7 ± 13 years and 12.8 ± 3.5 mL/min/1.73 m(2), respectively. Fifty-nine patients had KT, including 3 PLDKTs only (5.1% of total KTs and 9.4% of PAKT). Twenty-nine patients (90.6%) failed to receive PLDKT due to donor unavailability (25%), exclusion (28.6%), regression from donation (3.6%), and patient regression on starting dialysis (39.3%). In multivariate analysis, known primary kidney disease (P = 0.002), patient age (P = 0.031) and sex (P = 0.001) were independent predictors of achievement of KT in our center. However, PAKT was not significantly (P = 0.065) associated with the achievement of KT. Review of the literature revealed lower rates of PLDKT in Egypt than those in the literature. CONCLUSION: Patient age, sex, and primary kidney disease are independent predictors of achieving living donor KT. Despite its non-significant effect, PAKT may enhance the low rates of PLDKT. The main causes of non-achievement of PLDKT were patient regression on starting regular dialysis and donor unavailability or exclusion. Baishideng Publishing Group Inc 2023-05-25 2023-05-25 /pmc/articles/PMC10354566/ /pubmed/37476008 http://dx.doi.org/10.5527/wjn.v12.i3.40 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Cohort Study
Gadelkareem, Rabea Ahmed
Abdelgawad, Amr Mostafa
Reda, Ahmed
Azoz, Nashwa Mostafa
Zarzour, Mohammed Ali
Mohammed, Nasreldin
Hammouda, Hisham Mokhtar
Khalil, Mahmoud
Preemptive living donor kidney transplantation: Access, fate, and review of the status in Egypt
title Preemptive living donor kidney transplantation: Access, fate, and review of the status in Egypt
title_full Preemptive living donor kidney transplantation: Access, fate, and review of the status in Egypt
title_fullStr Preemptive living donor kidney transplantation: Access, fate, and review of the status in Egypt
title_full_unstemmed Preemptive living donor kidney transplantation: Access, fate, and review of the status in Egypt
title_short Preemptive living donor kidney transplantation: Access, fate, and review of the status in Egypt
title_sort preemptive living donor kidney transplantation: access, fate, and review of the status in egypt
topic Retrospective Cohort Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10354566/
https://www.ncbi.nlm.nih.gov/pubmed/37476008
http://dx.doi.org/10.5527/wjn.v12.i3.40
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