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. 2023 May 31;38(6):1528-1539.
doi: 10.1093/ndt/gfac333.

Trends in kidney transplantation rate across Europe: study from the ERA Registry

Rianne Boenink  1   2 , Anneke Kramer  1   2 , Rosalie E Tuinhout  1 , Emilie Savoye  3 , Anders Åsberg  4   5 , Alma Idrizi  6 , Julia Kerschbaum  7 , Ieva Ziedina  8 , Edita Ziginskiene  9   10 , Emanuel Farrugia  11 , Liliana Garneata  12   13 , Elena V Zakharova  14 , Samira Bell  15   16 , Miha Arnol  17   18 , Mårten Segelmark  19 , Kyriakos Ioannou  20 , Kristine Hommel  21 , Mai Rosenberg-Ots  22 , Evgueniy Vazelov  23 , Jaakko Helve  24   25 , Sándor Mihály  26 , Runólfur Pálsson  27   28 , Maurizio Nordio  29 , Nikola Gjorgjievski  30   31 , Aiko P J de Vries  32 , Nurhan Seyahi  33 , Winnie A Magadi  34 , Halima Resić  35 , Aleh Kalachyk  36 , Axel O Rahmel  37 , Ana A Galvão  38 , Radomir Naumovic  39   40 , Torbjörn Lundgren  41 , Mustafa Arici  42 , Johan M de Meester  43 , Alberto Ortiz  44 , Kitty J Jager  1   2 , Vianda S Stel  1   2
Affiliations

Trends in kidney transplantation rate across Europe: study from the ERA Registry

Rianne Boenink et al. Nephrol Dial Transplant. .

Abstract

Background: The aim of this study was to identify trends in total, deceased donor (DD) and living donor (LD) kidney transplantation (KT) rates in European countries.

Methods: The European Renal Association (ERA) Registry and the Global Observatory on Donation and Transplantation (GODT) databases were used to obtain the number of KTs in individual European countries between 2010 and 2018. General population counts were obtained from Eurostat or the national bureaus of statistics. The KT rate per million population (p.m.p.) and the average annual percentage change (APC) were calculated.

Results: The total KT rate in the 40 participating countries increased with 1.9% annually [95% confidence interval (CI) 1.5, 2.2] from 29.6 p.m.p. in 2010 to 34.7 p.m.p. in 2018, reflecting an increase of 3.4 p.m.p. in the DD-KT rate (from 21.6 p.m.p. to 25.0 p.m.p.; APC 1.9%; 95% CI 1.3, 2.4) and of 1.5 p.m.p. in the LD-KT rate (from 8.1 p.m.p. to 9.6 p.m.p.; APC 1.6%; 95% CI 1.0, 2.3). The trends in KT rate varied widely across European countries. An East-West gradient was observed for DD-KT rate, with Western European countries performing more KTs. In addition, most countries performed fewer LD-KTs. In 2018, Spain had the highest DD-KT rate (64.6 p.m.p.) and Turkey the highest LD-KT rate (37.0 p.m.p.).

Conclusions: The total KT rate increased due to a rise in the KT rate from DDs and to a lesser extent from LDs, with large differences between individual European countries.

Keywords: Europe; kidney transplantation; trends.

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Conflict of interest statement

No conflicts of interest were declared.

Figures

Graphical Abstract
Graphical Abstract
Figure 1:
Figure 1:
KT rate in 2010 and 2018 p.m.p. for the 40 European countries combined (ALL) and by country. Total KT rate (A), DD-KT rate (B) and LD-KT rate (C). Discrepancy may exist between the APC trends (increasing or decreasing transplantation rate) in Tables 1–3 and the trends (up or down arrow) in this figure since this figure only displays the difference in transplantation rate between the year 2010 and 2018 and not the average annual change over the entire study period. Country abbreviations are shown in Supplementary data, Fig. S1.
Figure 2:
Figure 2:
KT rate p.m.p. in 2010 and 2018 and the average APC per donor type. (A) Total KT rate in 2010 p.m.p. (B) Total KT rate in 2018 p.m.p. (C) The APC between 2010 and 2018 with zero joinpoints (i.e. one trend for the entire study period) for the total KT rate. (D) DD-KT rate in 2010 p.m.p. (E) DD-KT rate in 2018 p.m.p. (F) The APC between 2010 and 2018 with zero joinpoints (i.e. one trend for the entire study period) for the DD-KT rate. (G) LD-KT rate in 2010 p.m.p. (H) LD-KT rate in 2018 p.m.p. (I) The APC between 2010 and 2018 with zero joinpoints (i.e. one trend for the entire study period) for the LD-KT rate.
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