Purpose: To compare long-term patient survival and graft function (≥ 20 years) for all types of solid organ transplants (SOTs) and to define the state-of-the-art in SOT outcomes.

Methods: Based on OPTN data as of 7-31-12, we analyzed 46,345 transplants (txs) performed between 10/1987 and 12/1991 on CsA and AZA maintenance immuno-suppression. SOT types as well as patient survival and graft function were computed. Only deceased donor SOTs and only recipients ≥ 18 years of age were included in this analysis. Due to very small numbers, intestine (INT) and liver (LI)/INT SOTs were not included in the comparison. Survival and function rates were computed by Kaplan/Meier.

Results: 20-year patient survival rates were highest for KI, pancreas(PA)/ kidney(KI), and LI txs recipients (see table 1), lowest, for lung, heart/lung, and LI/KI recipients.

20-year graft function rates were highest for LI and PA/KI recipients. Overall results were best for LI and PA/KI recipients and worst for lung, heart/lung and LI/KI recipients. The long-term results for solitary intestine, lung, and pancreas txs were disappointing; the combination with another organ (LI/ INT, heart/lung, PA/KI) resulted in significantly improved outcome possibly due to immunological reasons that were not studied. Of the four most frequently transplanted organs (KI, LI, heart, PA/KI), 20-year patient survival ranged between 37% (PA/KI), and 19% (heart); 20-year graft survival, between 21% (LI) and 13% (KI).

Conclusions: 20-year patient survival and graft function rates vary substantially between different types of SOTs: while patient survival was highest for KI and PA/KI and lowest for lung tx recipients, graft function was highest for LI and lowest for lung tx recipients. The results of the solitary organ txs with the lowest long-term graft function (INT, lung, PA) improved significantly when transplanted in combination with another organ (LI, heart, KI).

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