A pre-emptive kidney transplant is a kidney transplant that takes place before your kidney function deteriorates to the point of needing dialysis to replace the normal filtering function of the kidneys.
Currently, most kidney transplants are performed on people who are on dialysis because their kidneys are no longer able to adequately clean impurities from the blood.
Pre-emptive kidney transplant is considered the preferred treatment for end-stage kidney disease, but only about 20 percent of kidney transplants are performed pre-emptively in the U.S.
Several factors have been linked to the lower than expected rate of pre-emptive kidney transplants, such as:
- Shortage of donor kidneys
- Lack of access to transplant centers
- Low rates of physician referrals for the procedure among candidates of lower socio-economic status
- Lack of physician awareness of current guidelines
Why it's done
The benefits of pre-emptive kidney transplant before dialysis for people with end-stage kidney disease include:
- Lower risk of rejection of the donor kidney
- Improved survival rates
- Improved quality of life
- Lower treatment costs
- Avoidance of dialysis and its related dietary restrictions and health complications
These benefits of pre-emptive kidney transplant are especially significant among children and adolescents with end-stage kidney disease.
Risks of pre-emptive kidney transplant include early exposure to the risks associated with surgery and potentially wasting native kidney function.
What you can expect
If your doctor recommends a pre-emptive kidney transplant, you will be referred to a transplant center for evaluation. You're also free to select a transplant center on your own or choose a center from your insurance company's list of preferred providers.
At the transplant center, your doctor and transplant team will conduct several tests to determine if a pre-emptive kidney transplant is appropriate for you. They'll consider a variety of factors, including:
- Level of kidney function
- Overall health
- Any chronic medical conditions that might affect transplant success
- Availability of a donor kidney
- Ability to follow medical instructions and take anti-rejection medications for the rest of your life
If you're approved for a pre-emptive kidney transplant and a living-donor kidney is available, the living-donor transplant procedure will be scheduled. If a kidney from a living donor is not available, you will be placed on a waiting list for a deceased-donor kidney transplant.