TY - JOUR
T1 - Time trends in preemptive kidney transplantation in Europe
T2 - an ERA registry study
AU - Kramer, Anneke
AU - Boenink, Rianne
AU - Mercado Vergara, Cynthia G.
AU - Bell, Samira
AU - Kerschbaum, Julia
AU - Rodríguez Arévalo, Olga L.
AU - Mazuecos, Auxiliadora
AU - de Vries, Aiko P.J.
AU - Reisæter, Anna V.
AU - Wong, Esther H.S.
AU - Lundgren, Torbjörn
AU - Valentin, María O.
AU - Ordoñez Alvarez, Flor A.
AU - Melilli, Edoardo
AU - Finne, Patrik
AU - Segelmark, Mårten
AU - Couchoud, Cécile
AU - Sørensen, Søren S.
AU - Ferraro, Pietro Manuel
AU - Arnol, Miha
AU - Arici, Mustafa
AU - Ortiz, Alberto
AU - Jager, Kitty J.
AU - Abramowicz, Daniel
AU - Stel, Vianda S.
AU - Hellemans, Rachel
N1 - Funding: The European Renal Association (ERA) Registry is funded by the ERA. This article was written by A. Kramer et al. on behalf of the ERA Registry which is an official body of the ERA. C.G.M.V. received funding from the Department of Nephrology from the Antwerp University Hospital.
PY - 2024/12
Y1 - 2024/12
N2 - Background. Preemptive kidney transplantation (PEKT) has better outcomes when compared with transplantation after dialysis. We aimed to examine trends in PEKT between 2000 and 2019 in Europe and to provide an overview of associated policies, barriers and initiatives.
Methods. Adult patients from 12 European countries who received a preemptive kidney transplant were included. The representatives of the registries providing these data were questioned on the policies, barriers and initiatives around PEKT.
Results. Between 2000 and 2019, 20 251 adults underwent PEKT [11 169 from living donors (LDs), 8937 from deceased donors (DDs)]. The proportion of first kidney transplantations that were preemptive more than doubled from 7% in 2000 to 18% in 2019, reflecting a similar relative increase for LD kidney recipients (from 21% to 43%) and DD kidney recipients (from 4% to 11%). Large international differences were found. The increase in PEKT was observed across all age, sex and primary renal disease groups. Countries had similar criteria for preemptive waitlisting. Barriers mentioned included donor shortage, late referral to the transplant center and long donor or recipient work-up. Suggested initiatives included raising awareness on the possibility of PEKT, earlier start and shorter work-up time for recipient and LD.
Conclusions. Over the last two decades the proportion of patients receiving a first kidney transplant preemptively has more than doubled, reflecting a similar relative increase for living and DD kidney recipients.
AB - Background. Preemptive kidney transplantation (PEKT) has better outcomes when compared with transplantation after dialysis. We aimed to examine trends in PEKT between 2000 and 2019 in Europe and to provide an overview of associated policies, barriers and initiatives.
Methods. Adult patients from 12 European countries who received a preemptive kidney transplant were included. The representatives of the registries providing these data were questioned on the policies, barriers and initiatives around PEKT.
Results. Between 2000 and 2019, 20 251 adults underwent PEKT [11 169 from living donors (LDs), 8937 from deceased donors (DDs)]. The proportion of first kidney transplantations that were preemptive more than doubled from 7% in 2000 to 18% in 2019, reflecting a similar relative increase for LD kidney recipients (from 21% to 43%) and DD kidney recipients (from 4% to 11%). Large international differences were found. The increase in PEKT was observed across all age, sex and primary renal disease groups. Countries had similar criteria for preemptive waitlisting. Barriers mentioned included donor shortage, late referral to the transplant center and long donor or recipient work-up. Suggested initiatives included raising awareness on the possibility of PEKT, earlier start and shorter work-up time for recipient and LD.
Conclusions. Over the last two decades the proportion of patients receiving a first kidney transplant preemptively has more than doubled, reflecting a similar relative increase for living and DD kidney recipients.
KW - Barriers
KW - Europe
KW - Preemptive kidney transplantation
KW - Trends
UR - https://www.scopus.com/pages/publications/85197588681
U2 - 10.1093/ndt/gfae105
DO - 10.1093/ndt/gfae105
M3 - Article
C2 - 38724446
AN - SCOPUS:85197588681
SN - 0931-0509
VL - 39
SP - 2100
EP - 2112
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
IS - 12
ER -