Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 Dec;37(4):100798.
doi: 10.1016/j.trre.2023.100798. Epub 2023 Sep 28.

What are the benefits of preemptive versus non-preemptive kidney transplantation? A systematic review and meta-analysis

Reshma Rana Magar  1 , Simon R Knight  1 , Umberto Maggiore  2 , Jeffrey A Lafranca  3 , Frank J M F Dor  4 , Liset H M Pengel  5
Affiliations
Free article
Meta-Analysis

What are the benefits of preemptive versus non-preemptive kidney transplantation? A systematic review and meta-analysis

Reshma Rana Magar et al. Transplant Rev (Orlando). 2023 Dec.
Free article

Abstract

Opting for a preemptive kidney transplant (PKT) can help avoid costs and morbidity associated with dialysis. However, while multiple studies have shown clinical benefits of PKT, other studies have not demonstrated this, leading to controversy in the literature regarding the exact benefits of PKT. Therefore, this study aimed to determine the clinical outcomes of PKT versus non-preemptive kidney transplantation (nPKT) in adult patients. Multiple databases were searched up to May 4, 2022. Independent reviewers selected studies for inclusion and extracted relevant data. Risk of bias was assessed using the Downs and Black checklist. Eighty-seven studies including 859,715 adult kidney transplant patients were included the review. The risk of patient death (relative risk [95% confidence interval] 0.74 [0.60-0.91]) was significantly lower in PKT versus nPKT patients for living donor (LD) transplants, whereas the risk of overall graft loss was significantly lower in PKT compared to nPKT patients for both LD (0.72 [0.62-0.83]) as well as deceased donor (DD) transplants (0.80 [0.69-0.92]). The evidence suggests that LD PKT patients have a lower risk of patient death and graft loss compared to nPKT patients, and DD PKT patients have a lower risk of graft loss than nPKT patients.

Keywords: Adults; Meta-analysis; Outcomes; Preemptive kidney transplantation; Systematic review.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest SK and LHMP received royalties from the Transplant Library. SK received grants from NIHR, consulting fees from Organox and stock options from Ochre bio. SK is on the DSMB for NHSBT studies. FJMFD received lecture fees from Baxter, Sandoz, Chiesi, Astellas and consulting fees from Sandoz. FJMFD was a member of the Steering Group of the NHSBT Clinical Trials Unit until Feb 2023. FJMFD is the council member of ESOT, Council Member of the BTS, president of the Thematic Federation Equality, Diversity and Inclusivity of the UEMS, and the deputy chair of the NHSBT Kidney Advisory Group. UM received consulting fees Biotest, GSK, Hansa, Takeda, Astra Zeneca and Alexion, and lecture fees from Novartis, Sandoz, Atara, Astra Zaneca, Hansa and Alexion.