Listen as Mikel Prieto, M.D., Surgical Director of the Kidney and Pancreas Transplant Program at Mayo Clinic in Rochester, MN, discusses preemptive kidney donation. When a patient has end-stage kidney disease, they must replace the function of the kidneys with one of two renal replacement therapies: dialysis or kidney transplant. With dialysis therapy, a machine cleans the blood. Dialysis is only able to perform about 10 percent of the work a kidney does and can cause serious health problems. Kidney transplant is the preferred therapy. With preemptive kidney transplant a patient receives a kidney transplant, usually from a live donor, before needing to start dialysis. This is the best option for patients, as it can result in better function of the new kidney, enhance overall health and improve life expectancy.