Continuous Improvement in Long Term Survival of Kidney Transplants Over the Past Two Decades

E. D. Poggio¹, S. Arrigain², A. Wee³, D. C. Brennan⁴, J. D. Schold²

¹Nephrology, Cleveland Clinic, Cleveland, OH, ²Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, ³Urology, Cleveland Clinic, Cleveland, OH, ⁴Nephrology, Johns Hopkins, Baltimore, MD

Meeting: 2020 American Transplant Congress

Abstract number: 350

Keywords: Graft survival, Kidney transplantation, Outcome, Survival

Session Information

Session Name: Kidney Complications: Non-Immune Mediated Late Graft Failure

Session Type: Oral Abstract Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:45pm

Presentation Time: 3:39pm-3:51pm

Location: Virtual

*Purpose: Short-term kidney transplant (KTx) graft survival has improved during past decades, but prior research has indicated stagnation or minimally improving long-term outcomes. We studied 1- 5- and 10-year graft survival and calculated the observed and projected half-life in deceased donor (DD) and living donor (LD) KTx from ’95 to date.

*Methods: We examined the SRTR for all DD and LD adult KTx b/w 01/01/95 and 12/01/17. The cohort was grouped by eras spanning 4-5 yrs. We estimated Kaplan-Meier graft survival and for eras where median survival has not yet been observed, we fitted linear regression models to estimate half-lives.

*Results: 331,214 KTx were included, with 63.6% DD (n=210,664) and 36.4% LD (n=120,550). Age was 49.4 (13.7) yo and 39.7% were female. Observed DD half-life increased from 104 mo in era ’95-’99 to 125 mo in era ’05-’09 (p<0.001). The projected (* in tables) half-life for DD KTx b/w '14-'17 is 154 mo. In LDs, observed half-life increased from 164 mo in era '95-'99 to 174 mo in era '00-'04 (p<0.001). Projected half-life for LD KTx b/w '14-'17 is 279 mo. KM graphs show continuous improvement of long-term graft survival era by era.

*Conclusions: While short-term graft survival continues to improve, significant improvement in long-term survival is now occurring with expected current half-life in LDs exceeding 20 yrs and in DDs 13 yrs.

Graft Survival and Half-Life of DD Kidney Transplants
Era	N	12 mo	60 mo	120 mo	Half-Life
1995-1999	37,103	87.8	67.0	45.1	104
2000-2004	40,130	88.9	68.8	47.2	111
2005-2009	47,452	91.0	72.9	51.5	125
2010-2013	39,815	93.0	76.8		136*
2014-2017	46,164	94.3			154*

Graft Survival and Half-Life of LD Kidney Transplants
Era	N	12 mo	60 mo	120 mo	Half-Life
1995-1999	18,183	94.0	80.2	61.5	164
2000-2004	28,780	94.8	81.5	63.5	174
2005-2009	29,711	96.1	84.7	68.0	188*
2010-2013	22,245	97.1	86.9		214*
2014-2017	21,631	97.9			279*

To cite this abstract in AMA style:

Poggio ED, Arrigain S, Wee A, Brennan DC, Schold JD. Continuous Improvement in Long Term Survival of Kidney Transplants Over the Past Two Decades [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/continuous-improvement-in-long-term-survival-of-kidney-transplants-over-the-past-two-decades/. Accessed May 13, 2025.

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