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Transplants of kidneys urged before dialysis

BOSTON — Kidney transplants are less likely to be rejected in patients who have never undergone dialysis, a nationwide study of 8,481 transplant recipients concluded in Thursday's New England Journal of Medicine.

"Transplantation of a kidney from a living donor without long-term dialysis was associated with a 52 percent reduction" in the chances that the new kidney will fail in the first year, according to researchers, led by Dr. Kevin Mange of the University of Pennsylvania in Philadelphia.

The risk of the transplant failing was even lower — at 82 percent — in the second year after the transplant.

Mange and his colleagues said the success rate may be higher for people who have not had dialysis because dialysis may prime the immune system to reject a new kidney.

An alternative explanation is that the people who did not require dialysis right away may have been healthier to start with, or more willing to follow their prescribed medical treatments.