Long-term graft and patient survival after kidney transplant on positive trajectory
BOSTON — In the past 3 decades, survival rates of both allograft and patients following kidney transplant have improved, according to a speaker at the American Transplant Congress.
“I think there are a lot of reasons for optimism when it comes to kidney transplant outcomes,” Catherine Wu, of Baylor College of Medicine in Houston, said during an abstract presentation. “Prior research has shown that short-term, defined as 6 months to 1 year, graft failure has decreased greatly over time. Long-term graft and patient survival have also improved. These improvements have occurred despite the fact that there have been expanded criteria for both donors and recipients. However, some of the things that these previous studies have not considered is that long-term outcomes may have been influenced by short-term outcomes.”
To eliminate the effects of short-term outcomes that could “cloud” the long-term outcomes when assessing graft and patient survival, researchers used the United Network for Organ Sharing database to conduct a retrospective analysis of 250,000 recipients who were transplanted between 1991 and 2017 and who had already survived for 1 year after transplant.
Researchers found that compared with patients transplanted between 1991 and 1995 and between 1996 and 2000, patients transplanted between 2011 and 2016 had a 64% and a 36% decrease in risk for mortality, respectively.
In addition, researchers observed the 5-year periods from 1996 to 2017 showed decreasing hazard ratios for both patient mortality (1996 to 2000 HR = 0.86; 2011 to 2017 HR = 0.84) and graft failure (1996 to 2000 HR = 0.91; 2011 to 2017 HR = 0.83).
“In conclusion, kidney transplant long-term graft and patient survival have improved over the last 30 years, making transplant safer than ever before,” Wu said. “Future research should focus more on elucidating what factors could have affected these long-term outcomes and other clinical comorbidities.” – by Melissa J. Webb
Wu C, et al. Abstract 8. Presented at: American Transplant Congress. June 1-5, 2019; Boston.
Disclosure: Wu reports no relevant financial disclosures.