The OPTN/UNOS Renal Transplant Registry

Area of Science:

• Nephrology
• Transplantation immunology
• Public health

Background:

• Graft survival rates for renal transplants have shown modest improvements over time.
• Patient survival rates have seen a slight decline, particularly for recipients of living and younger deceased donor kidneys.

Purpose of the Study:

• To analyze trends in graft and patient survival rates for first renal transplants.
• To evaluate the impact of donor type, donor age, and HLA matching on transplant outcomes.
• To assess changes in transplant recipient demographics and their effect on survival rates.

Main Methods:

• Analysis of data from the OPTN/UNOS Renal Transplant Registry for transplants performed between 1990 and 2004.
• Comparison of graft and patient survival rates across different time intervals (1990-1994, 1995-1999, 2000-2004).
• Stratification of analysis by donor type (living, deceased standard criteria, deceased expanded criteria) and recipient characteristics.

Main Results:

• 10-year graft survival increased modestly for living and deceased donor transplants, but patient survival declined slightly.
• 5-year graft and patient survival rates for 2000-2004 showed improvements for living and standard criteria deceased donor transplants compared to older donor transplants.
• Increasing median recipient age for standard criteria deceased donor transplants may explain the lack of long-term graft survival improvement.

Conclusions:

• While graft survival shows some improvement, particularly for younger recipients, overall patient survival has stagnated or declined slightly.
• The increasing age of recipients for standard criteria deceased donor transplants is a potential factor limiting long-term graft survival.
• Further research is needed to understand and address the factors contributing to the observed trends in renal transplant outcomes.