Pre-emptive kidney transplantation is when a kidney transplant is performed prior to starting dialysis. There have been multiple studies that show that avoiding dialysis and performing a transplant prior to initiating dialysis is advantageous to the recipient in many ways.
Some of these advantages are:
a) improved patient survival
b) transplanted kidneys last longer
c) recipients tend to return to work much faster
d) the quality of life is much better when compared to receiving a transplant after being on dialysis
e) lower medical costs in the long-term
Advantages of avoiding dialysis include:
a) decreased infections in the dialysis catheters
b) there is no need for a permanent dialysis access, therefore no surgery required and hence no surgery related complications
c) decreased heart attacks, strokes and sudden deaths associated with dialysis
The average waiting period for a deceased donor transplant is between 3 to 5 years. Keeping this time frame in mind, performing a transplant earlier is advantageous due the reasons mentioned above, and also if the recipient has a potential living donor.
Potential advantages of a living donor transplant, compared to a transplant from a deceased donor include:
a) If the donor and recipient are family members and genetically related, the match between them is better and hence have a lower chance of rejection.
b) The transplanted kidney from a live donor usually works immediately as compared to a deceased donor kidney, that could take some time to start working.
c) The procedure can be done at a convenient time and can be planned in advance which works better for both the donor and the recipient.