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. 2010 Nov;10(11):2502-11.
doi: 10.1111/j.1600-6143.2010.03292.x.

Wait list death and survival benefit of kidney transplantation among nonrenal transplant recipients

J R Cassuto  1 , P P Reese, S Sonnad, R D Bloom, M H Levine, K M Olthoff, A Shaked, A Naji, P Abt
Affiliations

Wait list death and survival benefit of kidney transplantation among nonrenal transplant recipients

J R Cassuto et al. Am J Transplant. 2010 Nov.

Abstract

The disparity between the number of patients waiting for kidney transplantation and the limited supply of kidney allografts has renewed interest in the benefit from kidney transplantation experienced by different groups. This study evaluated kidney transplant survival benefit in prior nonrenal transplant recipients (kidney after liver, KALi; lung, KALu; heart, KAH) compared to primary isolated (KA1) or repeat isolated kidney (KA2) transplant. Multivariable Cox regression models were fit using UNOS data for patients wait listed and transplanted from 1995 to 2008. Compared to KA1, the risk of death on the wait list was lower for KA2 (p < 0.001;HR = 0.84;CI = 0.81-0.88), but substantially higher for KALu (p < 0.001; HR = 3.80;CI = 3.08-4.69), KAH (p < 0.001; HR = 1.92; CI = 1.66-2.22), and KALi (p < 0.001; HR = 2.69; CI = 2.46-2.95). Following kidney transplant, patient survival was greatest for KA1, similar among KA2, KALi, KAH, and inferior for KALu. Compared to the entire wait list, renal transplantation was associated with a survival benefit among all groups except KALu (p = 0.017; HR = 1.61; CI = 1.09-2.38), where posttransplant survival was inferior to the wait list population. Recipients of KA1 kidney transplantation have the greatest posttransplant survival and compared to the overall kidney wait list, the greatest survival benefit.

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Conflict of interest statement

The other authors report no financial disclosures. There are no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Percent change in the size of the kidney waitlist compared to the 1995 kidney wait list population reference group, by year.
Figure 2
Figure 2
Adjusted 3 year kidney wait list survival.
Figure 3
Figure 3
5 year adjusted survival benefit of transplantation compared to remaining on the wait list.
Figure 4
Figure 4
5 year adjusted transplant survival compared to survival of the entire wait list
Figure 5
Figure 5
10 year adjusted post transplant patient and death censored graft survival.
See this image and copyright information in PMC

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