Can renal transplantation be done safely without prior dialysis therapy?

The complications, cost, and inconvenience associated with pretransplant hemodialysis or peritoneal dialysis would be minimized if transplantation were instituted without prior dialysis. Uremia, however, has been demonstrated to impart a wide range of immunosuppressive effects in clinical and experimental investigation. Indeed, several authors have suggested that chronic pretransplant dialysis may be required to attain successful engraftment. This investigation was undertaken to determine whether renal transplantation without prior chronic dialysis can be safely performed without an adverse effect on outcome.