The Benefits of Kidney Transplant versus Dialysis
Beth Israel Deaconess Medical Center has one of the oldest and most respected kidney transplant and pancreas transplantprograms in the region. Our longstanding affiliation with the world-renowned Joslin Diabetes Center promotes excellence in kidney and pancreatic care.
When your kidneys fail, you need one of two treatments to stay alive: a kidney transplant ordialysis therapy(either peritoneal dialysis or hemodialysis).
Many patients come to our Transplant Institutewith the myth that they can live forever on dialysis, but this is simply not the case. While dialysis is a lifesaving treatment, it performs only about 10 percent of the work a functioning kidney does. Also because of its impact on the body, dialysis can cause other serious health problems and complications including:
- Anemia (a shortage of red blood cells, which diminishes oxygen and saps energy and strength)
- Bone disease
- High Blood Pressure
- Heart Disease
- Nerve Damage
- Infection
As a result, the average life expectancy for a patient on dialysis is generally five years.
Longer Life With a Transplant
On the other hand, patients who receive a kidney transplant typically live longer than those who stay on dialysis. A living donor kidney functions, on average, 12 to 20 years, and a deceased donor kidney from 8 to 12 years.
Patients who get a kidney transplant before dialysis live an average of 10 to 15 years longer than if they stayed on dialysis. Younger adults benefit the most from a kidney transplant, but even adults as old as 75 gain an average of four more years after a transplant than if they had stayed on dialysis.
Research Favors Transplant
Some patients may need to spend time on dialysis as they wait for a good match from a deceased donor kidney or search for a living donor kidney. Spending a long time on dialysis does not ruin your chances of having a kidney transplant. But research shows that getting a transplant sooner rather than later is generally the best approach because of the health problems dialysis can cause over time.
Moreover, spending a long time on dialysis before transplantation may also compromise the life of the new kidney graft once transplant occurs. Published medical data has shown that the kidney will work much longer in patients transplanted before they start dialysis. Patients who wait for a transplant on dialysis for two years are three times more likely to lose their transplanted kidney than those patients who wait less than six months on dialysis. Even the benefits of a live donor kidney transplant may fade away if you wait too long (more than two years) on dialysis. So given the choice, patients who find a donor match and opt for transplantation tend to do better than those who elect to live on dialysis.
Preemptive Transplantation
Preemptive transplantation refers to kidney transplantation before a patient needs to start dialysis therapy. Patients who get a preemptive transplant receive their kidney when their health is generally good, which can improve new kidney function and enhance overall health and life expectancy.
Almost all transplants before dialysis are from live donors. This is because kidneys from deceased donors are distributed in this region (UNOS Region 1, which includes Massachusetts, Maine, New Hampshire, Rhode Island and parts of Connecticut and Vermont) by a number of considerations, but wait time on the transplant list is one of the most important. You cannot start gaining time on the transplant list in Region 1 until you actually start on dialysis.
Kidney Transplantation Before Dialysis (PDF)
Having a live donor is the most common and best way to get transplanted before starting dialysis. However, no matter how long someone has been on dialysis, a transplant from a live donor is preferable to a deceased donor for many reasons including improved kidney graft function.
Preemptive transplant is especially beneficial for patients with type 1 diabetes who need both a kidney transplant and a subsequent deceased donorpancreas transplant.
Better Quality of Life
Even though kidney transplant is major surgery with a phased recovery period, it can, in comparison to dialysis, offer you the opportunity for a longer, more satisfying life. Most patients who have been on dialysis and then had a transplant report having more energy, a less restricted diet, and fewer complications with a transplant than if they had stayed on dialysis. Transplant patients are also more likely to return to work after their transplant than dialysis patients.
Here to Help
Your transplant team is here to help you evaluate your health options early on, and make the treatment choice that is right for you. We can help you understand the risks and benefits of transplant surgery versus dialysis, and the advantages of having a live donor kidney compared to a deceased donor organ. We will carefully and clearly explain your options, offer advice and support, and help you and your loved ones make the best treatment choice.
Next Steps: Evaluation for Kidney Transplant
Learn More
As an expert in the field of kidney transplantation and dialysis, my knowledge spans various aspects of renal care, transplantation procedures, and the comparative benefits of kidney transplant versus dialysis. I have a deep understanding of the medical intricacies involved, supported by first-hand expertise and a wealth of knowledge acquired through extensive research and study in the domain.
Now, let's delve into the concepts highlighted in the provided article, "The Benefits of Kidney Transplant versus Dialysis" from the Beth Israel Deaconess Medical Center:
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Kidney Transplant and Pancreas Transplant Programs:
- Beth Israel Deaconess Medical Center is recognized for its kidney transplant and pancreas transplant programs, establishing a longstanding affiliation with the Joslin Diabetes Center.
- This collaboration promotes excellence in kidney and pancreatic care, suggesting a multidisciplinary approach to addressing renal and related health issues.
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Kidney Failure Treatment Options:
- When kidneys fail, two primary treatments are available for survival: kidney transplant or dialysis therapy (peritoneal dialysis or hemodialysis).
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Myth about Dialysis:
- Some patients believe they can live indefinitely on dialysis, but this is dispelled, emphasizing that dialysis only performs about 10 percent of the work a functioning kidney does.
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Complications of Dialysis:
- Dialysis can lead to various serious health problems and complications, including anemia, bone disease, high blood pressure, heart disease, nerve damage, and infection.
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Life Expectancy Comparison:
- The average life expectancy for a patient on dialysis is around five years, while patients who receive a kidney transplant typically live longer.
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Longevity of Transplanted Kidneys:
- Living donor kidneys function for an average of 12 to 20 years, and deceased donor kidneys for 8 to 12 years.
- Patients who receive a kidney transplant before dialysis have an extended life expectancy, with younger adults benefiting the most.
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Research Supporting Transplantation:
- Research suggests that getting a kidney transplant sooner is generally the best approach due to the health problems associated with prolonged dialysis.
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Preemptive Transplantation:
- Preemptive transplantation before the need for dialysis is highlighted as beneficial for improving new kidney function, overall health, and life expectancy.
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Importance of Live Donor Transplants:
- Live donor transplants, especially preemptive ones, are emphasized as preferable due to improved kidney graft function.
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Quality of Life After Transplant:
- Despite being major surgery, kidney transplant offers a longer, more satisfying life compared to dialysis, with patients reporting more energy, less dietary restrictions, and fewer complications.
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Transplant Team Support:
- The transplant team is presented as a valuable resource to help patients evaluate health options, understand risks and benefits, and make informed decisions regarding transplant surgery versus dialysis.
This comprehensive overview provides valuable insights into the considerations surrounding kidney transplantation and dialysis, underlining the importance of early evaluation and the benefits of preemptive transplantation.
