Kidney

Data for short and long-term graft failure rates and survival for deceased and living kidney transplant recipients are shown here.

The figure below shows all-cause graft failure (top panel) and death-censored graft failure (return to dialysis or re-transplant; bottom panel) data for 6-month, 1-year, 3-year, 5-year and 10-year periods (Hart et al., 2017) for deceased kidney donor recipients (left panel) and living kidney donor recipients (right panel).

Risk of graft failure or death in kidney transplant recipients computed using Kaplan-Meier computation (Hart et al., 2016).

Figure 6: Risk of graft failure or death in kidney transplant recipients computed using Kaplan-Meier computation (Hart et al., 2016).
Key: GF, all-cause graft failure: any graft failure; DCGF, death-censored graft failure: return to dialysis or retransplant; DWF, death with function: no graft failure before death. 

Evaluation of 119 kidney transplant recipients for somatic comorbidities using the Ifudu comorbidity index (Ifudu et al., 1998), identified non-ischaemic heart disease/hypertension (63%), visual impairment (35%), low back pain, spine or joint disorders (25%) and musculoskeletal disorders (24%) as the most common chronic illnesses. Overall, 90% of subjects had at least one medical comorbidity (Hollisaaz et al., 2007).

Chronic kidney disease (CKD) and the complications of CKD are highly prevalent in renal transplant recipients. Examination of 459 recipients revealed that CKD was present in 90% of patients with 60% of patients in CKD Stage 3 with a glomerular filtration rate (GFR) between 30 and 59 mL/min/1.73 m2. Hypertension was present in 86% of renal transplant recipients (Karthikeyan et al., 2004).

A systematic comparison of short term and long-term kidney graft survival between Europe (Collaborative Transplant Study (CTS) data) and the United States (United Network for Organ Sharing (UNOS) data) found that 1-year graft survival rates were similar (Europe 90.6% ± 0.4, for all ages; US white 91.1% ± 0.5; US black 88.7% ± 0.7; US hispanic 91.5% ± 0.8, for all ages). However, both 5-year and 10-year European graft survival rates were superior to those in the US across all age and ethnic groups. Five-year survival rates for all ages were 77.0% ± 0.6 for European; 71.3% ± 0.8 for US white; 62.5% ± 1.2 for US black; and 72.9% ± 1.6 for US hispanic groups. Ten-year survival rates were 56.5% ± 0.8 for European; 45.7% ± 1.0 for US white; 33.7% ± 1.5 for US black; and 48.2% ± 2.3 for US hispanic groups. The differences in graft survival were most disparate for younger kidney recipients (0–39 age group) and black patients (Gondos et al., 2013).