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Am J Transplant. 2016 Mar;16(3):1007-14. doi: 10.1111/ajt.13592. Epub 2016 Feb 4.

Underutilization of Timely Kidney Transplants in Those With Living Donors.

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Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
Division of Nephrology and Hypertension, William J. von Liebig Center for Transplantation, Mayo Clinic, Rochester, MN.
Kidney Epidemiology and Cost Center, University of Michigan, Ann Arbor, MI.
Department of Nephrology and Hypertension and Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
Division of Transplant Surgery, Departments of Surgery and Immunology, William J von Liebig Center for Transplantation, Mayo Clinic, Rochester, MN.


Preemptive kidney transplant (PKTx) and kidney transplant (KTx) within 1 year of dialysis initiation have been associated with superior outcomes. Wait times should be minimal for transplants with living donors; however, there is lack of literature studying utilization of timely KTx in this population. We designed this retrospective study using data from United Network for Organ Sharing Standard Transplant Analysis and Research files from 2000 to 2012 to assess the trends in utilization of PKTx and Early KTx (combination of PKTx or transplant within 1 year of dialysis initiation) in recipients of living donor KTx. Only 32.6% transplants were PKTx, and 61.9% were Early KTx. A significant improvement in proportion of PKTx was seen from 27.5% in 2000 to 35.4% in 2006, with no change since. Similarly, the proportion of Early KTx increased from 61.4% in 2000 to 63.6% in 2006, with no increase since. Similar results were seen after adjusted analysis and were independent of living donor type. Although there was some improvement in utilization of timely transplants in the early part of the last decade, there has been no improvement since. Considering the benefits of timely kidney transplant, it is important to understand the reasons behind the same and to improve utilization.


clinical research; donors and donation; kidney transplantation; living donor; living, kidney transplantation; nephrology; practice

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