The following is a summary of “Time trends in preemptive kidney transplantation in Europe: an ERA Registry study,” published in the May 2024 issue of Nephrology by Kramer et al.

Preemptive kidney transplantation (before dialysis) seems to produce better outcomes when compared to transplantation after dialysis.

Researchers conducted a retrospective study analyzing the prevalence of preemptive kidney transplants in Europe over two decades and understanding the factors influencing these trends, including policies and initiatives. 

They studied adult patients from 12 European countries who underwent preemptive kidney transplantation. Representatives from these registries were interviewed about policies, barriers, and initiatives related to preemptive kidney translation. 

The results showed that between 2000 and 2019, Around 20,251 adults got preemptive kidney transplants (11,169 from living donors, 8,937 from deceased donors). The proportion of kidney transplants that were preemptive more than doubled from 7% in 2000 to 18% in 2019. This increase was also seen across living donor kidney recipients (21% to 43%) and deceased donor kidney recipients (4% to 11%). These observations were similar across all age, sex, and primary renal disease groups. Barriers included donor shortage, late referrals to the transplant center, and long donor or recipient work-up. Suggestions included raising awareness on the possibility of an early start and shorter work-up time for the recipient and living donor. 

Investigators concluded that in the past 20 years, the number of patients receiving their first kidney transplant preemptively has more than doubled. This increase was seen both in recipients of kidneys from living and deceased donors.

Source: academic.oup.com/ndt/advance-article/doi/10.1093/ndt/gfae105/7667919