Attitudes toward Restored Kidney Transplantation among Dialysis Patients: Responses to a Questionnaire
Miyako Takagi

Abstract
By the end of 2012, more than 300,000 individuals across Japan were receiving dialysis for deteriorating kidney function. Approximately 38,000 patients begin dialysis each year, and approximately 30,000 die. After registering on the waiting list, patients wait for an average of 14 years to receive a kidney transplant because the number of cadaveric renal donors is extremely low in Japan. Between January 2012 and March 2013, we conducted a questionnaire survey with the cooperation of 70 hospitals in order to investigate the opinions of dialysis patients. Responses were obtained from 2727 dialysis patients, of which 91% had not enrolled in the kidney transplant recipient registry because of their advanced age, lower possibility of a transplant, or lack of knowledge regarding transplantation. In particular, the opinions of dialysis patients regarding the transplantation of surgically restored cancerous kidneys as a new donor source was investigated. Forty-five percent patients recognized restored kidney transplantation as medical care; nevertheless, restored kidney transplantation is currently not allowed in Japan. The ratio of patients accepting restored kidney transplantation is not worse than the number of patients who accept living donor renal transplantation as medical care (54.2%). In response to the question “When restored kidney transplantation becomes an available treatment, would you choose to undergo this type of transplantation,” a total of 548 patients (20.1%) replied positively. When we subanalyzed dialysis patients who were applicants for living donor renal transplantation, 178 of 332 patients (53.6%) indicated that they would choose to undergo restored kidney transplantation, while 59 patients (17.8%) indicated that they would not. Even among the nonapplicants for living donor renal transplantation, 354 of 2283 patients (15.5%) indicated that they would accept this treatment. In countries like Japan, where the demand for donated kidneys far exceeds the supply, restored kidneys may be added to the donor pool to alleviate the long waiting time and easing the suffering of patients who require transplantation.

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