The OPTN/UNOS Renal Transplant Registry

J Michael Cecka
Clinical Transplants 2005, : 1-16
The 10-year graft survival rates for first renal transplants performed during 1990-1994 and 1995-1999 and reported to the OPTN/UNOS Renal Transplant Registry increased from 57-58% for living donor transplants, from 42-46% for deceased donors aged 60 or under, and from 22-28% for donors over age 60 comparing the 2 intervals. These modest increases were accompanied by a 2% decline in 10-year patient survival for recipients of living and younger deceased donor grafts and a 1% improvement in patient survival for recipients of older donor kidneys. The 5-year graft and patient survival rates for transplants performed between 2000 and 2004 were 80% and 90% for living donor, 69% and 90% for standard criteria deceased donor and 55% and 82% for expanded criteria donor transplants, respectively. There was no significant improvement when compared to the 1995-1999 period for any of these groups and patient survival had declined by 1% among recipients of living or standard criteria deceased donors. recipients of living or standard criteria deceased donor kidneys had a 6-7% higher 5-year survival rate and longer graft half-lives than recipients of HLA mismatched kidneys. The number of local HLA-DR matched transplants (excluding zero-HLA-ABDR mismatched grafts) has been declining since 1998 and was affected by the activity of the local donation service area (presumably reflecting the size of the waiting list). There was a modest increase in the percentage of broadly sensitized recipients transplanted during 2002-2004 from 8-10% of standard deceased donor The median age for recipients of primary standard criteria deceased donor transplants increased from 43 during the period 1990-1994 to 51 during 2000-2004 and may explain the lack of improvement in long-term graft survival rates. When patients aged 19-35 were analyzed separately during the 3 periods, there was a 3-4% increase in actuarial or projected 10-year graft survival for recipients of living or younger deceased donor kidneys during each interval (p < 0.001). Changes to the kidney allocation algorithm that affect the role of HLA matching have not had a striking impact on the number or percentage of zero HLA-ABDR mismatched SCD transplants, which account for 16-17% of SCD transplants each year. The number and percentage of HLA-matched ECD transplants declined from 113 (12%) in 2001 to 63 (4%) in 2004. The 56% 5-year graft survival rate for recipients of HLA-matched ECD kidneys was not significantly better than that for HLA-mismatched grafts, whereas HLA-matched and from 2-4% of living donor kidney recipients that was temporally associated with improved technologies for detecting anti-HLA antibodies. The presence of panel reactive antibodies had almost no effect on 5-year graft survival among retransplanted patients. The number of transplants between spouses leveled off in 2001 at about 700 transplants each year. The number of non-spouse unrelated living donor transplants has increased 10-fold over the past 10 years to 1,341 in 2004 and does not appear to be slowing.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"