2202 Kidney Transplant Recipients with 10 Years of Graft Function: What Happens Next?
Article first published online: 9 OCT 2008
© 2008 The Authors Journal compilation © 2008 The American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 8, Issue 11, pages 2410–2419, November 2008
How to Cite
Matas, A. J., Gillingham, K. J., Humar, A., Kandaswamy, R., Sutherland, D. E. R., Payne, W. D., Dunn, T. B. and Najarian, J. S. (2008), 2202 Kidney Transplant Recipients with 10 Years of Graft Function: What Happens Next?. American Journal of Transplantation, 8: 2410–2419. doi: 10.1111/j.1600-6143.2008.02414.x
- Issue published online: 9 OCT 2008
- Article first published online: 9 OCT 2008
- Received 10 June 2008, revised 22 July 2008 and accepted for publication 07 August 2008
- Graft loss;
The ultimate goal of clinical transplantation is for the recipients to achieve long-term survival, with continuing graft function, that is equivalent to that of the age-matched general population. We studied subsequent outcome in kidney transplant recipients with 10 years of graft function. In all, 2202 kidney transplant recipients survived with graft function >10 years. For 10-year survivors, the actuarial 25-year patient survival rate for primary transplant living donor (LD) recipients was 57%; graft survival, 43%. For primary transplant deceased donor (DD) recipients, the actuarial 25-year patient survival rate was 39%; graft survival, 27%. The two major causes of late graft loss were death (with graft function) and chronic allograft nephropathy (tubular atrophy and interstitial fibrosis). The two major causes of death with function were cardiovascular disease (CVD) and malignancy. For nondiabetic recipients, the mean age at death with function from CVD was 54 ± 13 years; for diabetic recipients, 53 ± 7 years. By 20 years posttransplant, morbidity was common: >40% recipients had skin cancer (mean age for nondiabetic recipients, 53 ± 13 years; for diabetics, 49 ± 8 years), >10% had non-skin cancer (mean age for nondiabetic recipients, 53 ± 16 years; for diabetics, 46 ± 9 years), and >30% had CVD (mean age for nondiabetic recipients, 53 ± 15 years; for diabetics, 47 ± 9 years). We conclude that long-term transplant recipients have a high rate of morbidity and early mortality. As short-term results have improved, more focus is needed on long-term outcome.