As the time on dialysis increases your wife have more probability of exposure to infections and diaysis itself sensitises an individual . Moreover long duration on dialysis poses cardiac risk with recurrent hypotensive episodes during dialysis. So it is best to go for renal transplant at the earliest for best results if u r going to have live related transplant. If you are on waiting list of cadaver transplantation programme the time of transplantation is not in your hands so special precautions should be taken... 1. Avoid blood transfusions. .if needed EMERGENTLY go for leucodepleted packed cell transfusions 2. Maintain good nutritional status and Hb with monthly monitoring 3.Dont gain more than 2kgs in between dialysis..this can be done by restricted water in take i.e 4.Have regular cardiac checkups..