Kidney and pancreas transplantation in the United States, 1996-2005

Am J Transplant. 2007;7(5 Pt 2):1359-75. doi: 10.1111/j.1600-6143.2006.01781.x.

Abstract

Kidney and pancreas transplantation in 2005 improved in quantity and outcome quality, despite the increasing average age of kidney graft recipients, with 56% aged 50 or older. Geography and ABO blood type contribute to the discrepancy in waiting time among the deceased donor (DD) candidates. Allocation policy changes are decreasing the median times to transplant for pediatric recipients. Overall, 6% more DD kidney transplants were performed in 2005 with slight increases in standard criteria donors (SCD) and expanded criteria donors (ECD). The largest increase (39%) was in donation after cardiac death (DCD) from non-ECD donors. These DCD, non-ECD kidneys had equivalent outcomes to SCD kidneys. 1-, 3- and 5-year unadjusted graft survival was 91%, 80% and 70% for non-ECD-DD transplants, 82%, 68% and 53% for ECD-DD grafts, and 95%, 88% and 80% for living donor kidney transplants. In 2005, 27% of patients were discharged without steroids compared to 3% in 1999. Acute rejection decreased to 11% in 2004. There was a slight increase in the number of simultaneous pancreas-kidney transplants (895), with fewer pancreas after kidney transplants (343 from 419 in 2004), and a stable number of pancreas alone transplants (129). Pancreas underutilization appears to be an ongoing issue.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Graft Rejection / drug therapy
  • Graft Rejection / epidemiology
  • Graft Survival
  • Humans
  • Immunosuppression / methods
  • Kidney Transplantation / mortality
  • Kidney Transplantation / statistics & numerical data*
  • Kidney Transplantation / trends
  • Living Donors / statistics & numerical data
  • Pancreas Transplantation / statistics & numerical data*
  • Pancreas Transplantation / trends
  • Patient Selection
  • Survival Analysis
  • Tissue Donors / statistics & numerical data
  • United States