On the average, the wait for a cadaveric kidney transplant is one year. Hopefully, the patient will receive his transplant before he requires dialysis. If he develops uremic symptoms first, he can be maintained on dialysis for a few months until an organ comes along. Using this plan, there is minimal social and emotional displacement, and costs are less. I know of many patients who worked full time until transplanted, and returned to work a few weeks afterward.
Some patients achieve an impressive degree of rehabilitation on long-term dialysis.
Yet the numbers are fewer, and those who do well are less vigorous than the usual transplant patient. And there is another facet of this decision that is seldom discussed between physician and patient, the growing belief that transplant patients live significantly longer than dialysis patients, whatever their ages when treatment starts. Of course, any plan can be altered when circumstances change. If an early transplant fails, the patient can switch to dialysis, and vice versa. However, the fact that the patient and his physician have discussed a plan indicates that they both are prepared for the event of kidney failure, and that all will go smoother when the time comes.