What are the benefits of preemptive versus non-preemptive kidney transplantation? A systematic review and meta-analysis
Opting for a preemptive kidney transplant (PKT) can help avoid costs and morbidity associated with dialysis. However, while multiple studies have shown clinical benefits of PKT, other studies have not demonstrated this, leading to controversy in the literature regarding the exact benefits of PKT. Th...
| Main Authors: | , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2023
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| _version_ | 1826312705239154688 |
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| author | Rana Magar, R Knight, SR Maggiore, U Lafranca, JA Dor, FJMF Pengel, LHM |
| author_facet | Rana Magar, R Knight, SR Maggiore, U Lafranca, JA Dor, FJMF Pengel, LHM |
| author_sort | Rana Magar, R |
| collection | OXFORD |
| description | Opting for a preemptive kidney transplant (PKT) can help avoid costs and morbidity associated with dialysis. However, while multiple studies have shown clinical benefits of PKT, other studies have not demonstrated this, leading to controversy in the literature regarding the exact benefits of PKT. Therefore, this study aimed to determine the clinical outcomes of PKT versus non-preemptive kidney transplantation (nPKT) in adult patients. Multiple databases were searched up to May 4, 2022. Independent reviewers selected studies for inclusion and extracted relevant data. Risk of bias was assessed using the Downs and Black checklist. Eighty-seven studies including 859,715 adult kidney transplant patients were included the review. The risk of patient death (relative risk [95% confidence interval] 0.74 [0.60–0.91]) was significantly lower in PKT versus nPKT patients for living donor (LD) transplants, whereas the risk of overall graft loss was significantly lower in PKT compared to nPKT patients for both LD (0.72 [0.62–0.83]) as well as deceased donor (DD) transplants (0.80 [0.69–0.92]). The evidence suggests that LD PKT patients have a lower risk of patient death and graft loss compared to nPKT patients, and DD PKT patients have a lower risk of graft loss than nPKT patients. |
| first_indexed | 2024-03-07T08:01:10Z |
| format | Journal article |
| id | oxford-uuid:dd794c94-54a9-4ab7-85ea-6eddb38074fd |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-04-09T03:58:33Z |
| publishDate | 2023 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:dd794c94-54a9-4ab7-85ea-6eddb38074fd2024-03-26T10:45:24ZWhat are the benefits of preemptive versus non-preemptive kidney transplantation? A systematic review and meta-analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:dd794c94-54a9-4ab7-85ea-6eddb38074fdEnglishSymplectic ElementsElsevier2023Rana Magar, RKnight, SRMaggiore, ULafranca, JADor, FJMFPengel, LHMOpting for a preemptive kidney transplant (PKT) can help avoid costs and morbidity associated with dialysis. However, while multiple studies have shown clinical benefits of PKT, other studies have not demonstrated this, leading to controversy in the literature regarding the exact benefits of PKT. Therefore, this study aimed to determine the clinical outcomes of PKT versus non-preemptive kidney transplantation (nPKT) in adult patients. Multiple databases were searched up to May 4, 2022. Independent reviewers selected studies for inclusion and extracted relevant data. Risk of bias was assessed using the Downs and Black checklist. Eighty-seven studies including 859,715 adult kidney transplant patients were included the review. The risk of patient death (relative risk [95% confidence interval] 0.74 [0.60–0.91]) was significantly lower in PKT versus nPKT patients for living donor (LD) transplants, whereas the risk of overall graft loss was significantly lower in PKT compared to nPKT patients for both LD (0.72 [0.62–0.83]) as well as deceased donor (DD) transplants (0.80 [0.69–0.92]). The evidence suggests that LD PKT patients have a lower risk of patient death and graft loss compared to nPKT patients, and DD PKT patients have a lower risk of graft loss than nPKT patients. |
| spellingShingle | Rana Magar, R Knight, SR Maggiore, U Lafranca, JA Dor, FJMF Pengel, LHM What are the benefits of preemptive versus non-preemptive kidney transplantation? A systematic review and meta-analysis |
| title | What are the benefits of preemptive versus non-preemptive kidney transplantation? A systematic review and meta-analysis |
| title_full | What are the benefits of preemptive versus non-preemptive kidney transplantation? A systematic review and meta-analysis |
| title_fullStr | What are the benefits of preemptive versus non-preemptive kidney transplantation? A systematic review and meta-analysis |
| title_full_unstemmed | What are the benefits of preemptive versus non-preemptive kidney transplantation? A systematic review and meta-analysis |
| title_short | What are the benefits of preemptive versus non-preemptive kidney transplantation? A systematic review and meta-analysis |
| title_sort | what are the benefits of preemptive versus non preemptive kidney transplantation a systematic review and meta analysis |
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