Dialysis is life saving for patients with irreversible renal disease. However, it is associated with significant morbidity, a greater mortality than transplantation and is also expensive. Thus, transplantation is considered to be the treatment of choice for end-stage renal disease (ESRD). Our goal in this study was to determine whether the duration of chronic renal failure and hemodialysis before renal transplantation have any effect on one year survival of allograft function and whether longer duration of hemodialysis leads to unsatisfactory results as compared to shorter duration of dialysis. Graft function was reviewed among 1000 renal allograft recipients in Shiraz (Southern Iran) Organ Transplant Center. Patients were divided into two groups: Those who have been dialyzed for less than 3 months (group 1) and those who have been dialyzed for 3 months or more (group 2). Graft failure was defined as either a serum creatinine > 3 mg/dl and/or return to dialysis. Statistical analysis showed a significantly lower creatinine level at time of discharge for group 1 (1.1±0.3 vs. 1.7±0.4; p<0.05). There was no significant difference in mean creatinine levels at one year between the two groups (1.53±0.5 vs. 1.49±0.4). The incidence of various complications and causes of graft failure were the same among both groups.
Our data are not in favor of the notion that advanced uremia favors successful engraftment; in fact, early transplantation eliminates the cost, complications, and inconvenience of dialysis, leading to proper rehabilitation and a better quality of life. Besides, prolonged uremia and dialysis in pediatric age group interfers with growth and appropriate body image. Such finding support the idea of earlier transplantation.