Hill Terra M, Kerivan Lauren T, Mazzotti Diego R
Department of Surgery, The University of Kansas School of Medicine-Kansas City, Kansas City, Kansas.
Department of Internal Medicine, The University of Kansas School of Medicine-Kansas City, Kansas City, Kansas.
Kans J Med. 2025 Aug 15;18(4):86-88. doi: 10.17161/kjm.vol18.23625. eCollection 2025 Jul-Aug.
End-stage renal disease (ESRD) requires renal replacement therapy, either through pre-emptive transplantation (PET) or non-pre-emptive transplantation (non-PET). PET is associated with improved patient and allograft survival compared to non-PET; however, only 2.5% of patients in the United States undergo PET. The authors of this study report on mortality and allograft rejection rates in patients undergoing PET versus non-PET.
This single-center, retrospective study compared posttransplant complications between PET and non-PET in adults with ESRD. De-identified electronic health record data from 2017 to 2022 were analyzed. Odds ratios (ORs) for one-year post-transplant mortality and allograft rejection were calculated using unadjusted multivariate logistic regression (Model 1), adjusted for age and sex (Model 2), and further adjusted for comorbidities (Model 3).
A total of 787 patients with ESRD underwent kidney transplantation: 14% underwent non-PET and 86% underwent PET. Compared to PET, the ORs for one-year post-transplant mortality with non-PET were:Model 1: OR 1.76 (95% CI, 0.64-4.85; p = 0.27)Model 2: OR 2.02 (95% CI, 0.71-5.71; p = 0.19)Model 3: OR 1.86 (95% CI, 0.64-5.39; p = 0.24)For one-year allograft rejection, the ORs for non-PET versus PET were:Model 1: OR 1.63 (95% CI, 0.85-3.10; p = 0.13)Model 2: OR 1.61 (95% CI, 0.84-3.06; p = 0.15)Model 3: OR 1.60 (95% CI, 0.82-3.10; p = 0.16).
This single-center study found no statistically significant differences in one-year mortality or allograft rejection between patients undergoing PET and non-PET.
终末期肾病（ESRD）需要进行肾脏替代治疗，可通过抢先移植（PET）或非抢先移植（非PET）。与非PET相比，PET与患者及移植肾存活率的提高相关；然而，在美国只有2.5%的患者接受PET。本研究的作者报告了接受PET与非PET治疗的患者的死亡率和移植肾排斥率。
这项单中心回顾性研究比较了ESRD成年患者中PET和非PET术后的并发症。分析了2017年至2022年去识别化的电子健康记录数据。使用未调整的多变量逻辑回归（模型1）计算移植后一年死亡率和移植肾排斥的优势比（OR），对年龄和性别进行调整（模型2），并进一步对合并症进行调整（模型3）。
共有787例ESRD患者接受了肾移植：14%接受非PET，86%接受PET。与PET相比，非PET移植后一年死亡率的OR为：
模型1：OR 1.76（95%CI，0.64 - 4.85；p = 0.27）
模型2：OR 2.02（95%CI，0.71 - 5.71；p = 0.19）
模型3：OR 1.86（95%CI，0.64 - 5.39；p = 0.24）
对于移植后一年的移植肾排斥，非PET与PET的OR为：
模型1：OR 1.63（95%CI，0.85 - 3.10；p = 0.13）
模型2：OR 1.61（95%CI，0.84 - 3.06；p = 0.15）
模型3：OR 1.60（95%CI，0.82 - 3.10；p = 0.16）。
这项单中心研究发现，接受PET和非PET治疗的患者在一年死亡率或移植肾排斥方面没有统计学上的显著差异。
