**8. Conclusion**

A recent retrospective single center analysis in 38 PD and 268 HD patients describes a higher incidence of DGF and primary allograft failure for HD patients, but was no difference in acute

A case control study the incidence of DGF, defined as necessity to perform dialysis after transplantation, was analyzed in 117 PD and HD patients with a follow-up of 6 months. When matching the patients for age, sex, HLA compatibility PD-patients developed less DGF (23.1%) than HD patients (50.4%). In addition the decline of creatinine levels after transplantation was faster in PD patients. However, PD patients developed more acute rejection episodes, than HD patients, but creatinine levels after 6 weeks and 6 months were not different between the

Besides a bundle of published single center experiences with renal transplantation in PD patients we do have at least two registry studies reporting on the effect of pre-transplant

Data from the United Network of Organ Sharing on all cadaveric graft recipients who were dialysis-dependent at the time of transplantation were analyzed with respect to different outcomes in the immediate post-transplant period for HD or PD patients. In total more than 9000 patients were evaluated, showing that PD patients were on dialysis for a shorter period of time, were more likely to be white, had a better HLA match, and had a lower PRA. After adjusting for comorbidities, the odds of oliguria were 1.60 times higher in black HD patients compared with PD patients and 1.29 times higher in white HD patients. Also, the odds of requiring dialysis in the first week were 1.56 times higher in black HD patients versus PD patients and 1.40 times higher in white HD patients. The rate of acute rejection was similar during the first hospitalization. Therefore, the authors suggest that there may be an association between hemodialysis and delayed graft function assuming that differences in biocompati‐

A large retrospective analysis compared transplantation rates in PD and HD and outcomes after transplantation in more than 22000 patients from the years 1995 to 1998 in a US cohort. PD patients were more likely to be transplanted and their death censored graft failure was higher. However, mortality and overall graft failure were not different. Interestingly, the risk

Because of the in part contradictory data published in the literature we analyzed our own population of renal transplant recipients with the means of a retrospective case control study. Therefore, we chose 50 consecutive peritoneal dialysis patients transplanted since 1999. For match-pair-analysis, and as control group we selected the next hemodialysis patient subse‐ quently transplanted after each PD patient. Follow-up data were available with a maximum

Kruskal-Wallis Test and Chi-Square-Test were calculated, with assuming a p<0.05 as signifi‐

for early graft failure was higher for PD patients despite DGF was less common [39].

bility between the two modalities could potentially be responsible [38].

**7. Own experience with PD and renal transplantation**

of ten years after transplantation.

cant, for statistical purposes.

rejection episodes, long-term survivals, or renal function [36].

dialysis modality on renal transplant results.

198 Current Issues and Future Direction in Kidney Transplantation

groups [37].

Peritoneal dialysis (PD) is an established method of renal replacement therapy. PD and hemodialysis (HD) seem to be equivalent for long-term survival of the patients. Nevertheless, there is a beneficial effect of PD on patient survival after initiation of dialysis therapy. Probably, better preservation of residual renal function in PD patients compared to HD patients may be responsible for this effect.

Renal transplantation is the best treatment option for patients with endstage renal disease. The potential risk of infectious complications in PD patients after renal transplantation is attributed to the remaining PD catheter. However, this risk seems to be low and without effect on graft survival. For patients on HD a higher percentage of delayed graft function after renal trans‐ plantation is constantly reported in the literature. Nevertheless, long time patient and graft survival are not different between both treatment modalities.

Our own long-time clinical experience is congruent with the published literature and proves that peritoneal dialysis is a valuable treatment option for patients with end stage renal disease waiting for renal transplantation.
