Huang Yihung, Samaniego Millie
Division of Nephrology, University of Michigan, Michigan, USA.
Nephrol Ther. 2012 Nov;8(6):428-32. doi: 10.1016/j.nephro.2012.06.004. Epub 2012 Jul 28.
The benefits of preemptive kidney transplantation are manifold. By avoiding complications associated with dialysis, preemptive kidney transplantation offers significant benefits in terms of patient welfare and societal cost-saving. Patients transplanted preemptively also tend to enjoy better patient and graft survival, especially when done with a living-donor organ. While dialysis exposure limited to 6 to 12 months may not significantly impact post-transplant outcomes, longer period of dialysis has been shown to increase the risk of mortality, delayed graft function, acute rejection, and death-censored graft loss. The benefits of preemptive transplantation also extend to different age groups and end-stage kidney disease (ESKD) diagnoses. However, multiple barriers have prevented wider adoption of preemptive transplantation as the primary treatment of ESKD around the world. Timely preparation for ESKD and identification of living donors should be encouraged in all patients with advanced chronic kidney disease to increase the chance of preemptive transplantation.
preemptive kidney transplantation的益处是多方面的。通过避免与透析相关的并发症，preemptive kidney transplantation在患者福祉和节省社会成本方面提供了显著益处。接受preemptive移植的患者往往也享有更好的患者和移植物存活率，尤其是在使用活体供体器官进行移植时。虽然限于6至12个月的透析暴露可能不会对移植后结果产生显著影响，但已表明更长时间的透析会增加死亡风险、移植肾功能延迟、急性排斥反应以及死亡审查的移植物丢失风险。preemptive移植的益处还扩展到不同年龄组和终末期肾病（ESKD）诊断。然而，多种障碍阻碍了preemptive移植在全球范围内作为ESKD主要治疗方法的更广泛采用。应鼓励所有晚期慢性肾病患者及时为ESKD做准备并识别活体供体，以增加preemptive移植的机会。 （注：preemptive kidney transplantation 直译为“先发制人的肾移植”，结合语境这里应是指“优先肾移植”，但因要求不能添加解释，所以保留原文表述）
