Effects of Pre-Transplant Hemodialysis Timing on Post Kidney Transplant Outcomes

Abstract

Background: For kidney transplant patients on hemodialysis there is little evidence examining how timing of individual hemodialysis sessions prior to kidney transplant may affect short and long-term post-transplant outcomes. Methods: A retrospective cohort study of hemodialysis patients who received a kidney transplantation from 2006-2020, (n=661), was conducted using the Nova Scotia Health Multi-Organ Transplant Program’s Transplant Data Repository, which includes all transplant recipients from the Atlantic Canada provinces. The primary outcome of the study was delayed graft function, with secondary outcomes of transplant graft failure, length of stay, perioperative hypotension, postoperative hypotension. Outcomes were analyzed using either multivariable logistic regression or multivariable Fine and Gray regression. Results: The primary outcome of delayed graft function had an odds ratio of 0.78 (95% confidence intervals. 0.47-1.28) when comparing hemodialysis ≥1 day before transplant to hemodialysis the same day as transplant. Similarly, no significant relationship was seen between hemodialysis timing and secondary outcomes.