Patients with diabetes among those who show greatest improvement in transplant survival
Minority patients, patients with diabetes and older patients showed the most improvement in graft survival in the United States from 1995 to 2017, a study shows.
“Short-term and long-term kidney transplant graft survival has been improving over time, but whether this improvement in outcomes is more pronounced in the early (1 year) compared to later periods, and whether it is different among certain patient populations is unknown,” Emilio D. Poggio, MD, of the department of nephrology and hypertension of the Glickman Urological and Kidney Institute at the Cleveland Clinic, and colleagues wrote in an abstract presented at the virtual American Transplant Congress.
The researchers examined data from the Scientific Registry for Transplant Recipients, which included information on all deceased and living adult kidney transplants between Jan. 1, 1995 and Dec. 31, 2017. Patients were grouped by eras with a 4- to 5-year period and were then analyzed by type of transplant. Race, age groups and diagnoses were also reviewed.
“We calculated the unadjusted relative percent change in graft survival improvement at 1- and 5-years and the [hazard ratio] HR by adjusted Cox proportional models for patients transplanted during era ’95-’99 compared to patients transplanted in era ’14-’17,” the researchers wrote.
In total, 331,214 kidney transplants were reviewed, with 63.6% of recipients having a deceased donor (n=210,664) and 36.4% of transplants with a living donor (n=120,550).
“On average, 1-year graft survival has improved by 6.2% from ’95-’99 to ’14-’17 but this improvement was significantly more pronounced for longer-term survival (12.7% for 5-year graft survival in ’10-’13 vs. ’95-’99),” the authors wrote.
They concluded that while 1-year graft survival has improved from 1995 to date, “the more pronounced improvement is evident in 5-year graft survival. Importantly, while the long-term outcomes of all kidney transplant recipients are improving over time, minorities, older patients, those with higher comorbidities and recipients of living donors have improved the most.”
Reference: Poggio L, et al. Abstract #265. Presented at: American Transplant Congress; May 30-June 1, 2020. (virtual meeting).
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