Showing papers in "Transactions of the Medical Society of London in 1983"
TL;DR: Although from time to time there has been rivalry between transplantation and dialysis, it is now clear that they are complementary and whilst dialysis is a relatively safe procedure it imposes serious restrictions on the patient.
Abstract: When I first became interested in transplantation in 1959 patients with renal failure had no chance of treatment. They were made as comfortable as possible and died. In 1960, two notable events occurred; an effective immunosuppressive drug, namely azathioprine was introduced and Scribner showed that an arteriovenous shunt could be made to last a long time and allow a patient to be rescued from uraemia by repeated dialysis. Although from time to time there has been rivalry between transplantation and dialysis, it is now clear that they are complementary and whilst dialysis is a relatively safe procedure it imposes serious restrictions on the patient. He must be careful how much he drinks, watch his salt intake, and may suffer from complications from the arterio-venous fistula requiring revision of the anastomosis. He will have a chronic anaemia and worst of all, he has to be both physically and psychologically wedded to a complicated machine for several hours, two or three times a week. Maintaining a patient on dialysis is expensive in equipment but more so in terms of the medical, nursing and technical staff who support the patient, even though these costs are reduced when dialysis is conducted at home.
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