Survival rate of renal transplants, people post transplantation and in those on dialysis

The estimated survival rate of a renal transplant at one year is 84% and at 5 years 65%, american figures are slightly better. As such cadaveric renal transplantation can only be viewed as being palliative.

However, the major cause of death in patients in the first few years post transplantation is atherosclerosis. The rate of developement of atherosclerosis in patients on dialysis is greater that the rate of those with a functioning renal transplant.

The annual death rate of people on hemodialysis is 10% per annum.

Figure 8: Patient and graft survival in a group of more than 40,000 first kidney transplant recipients transplanted between October 1987 and December 1992 and reported to the United Network for Organ Sharing as of June 1995

As can be seen from the figure patient survival is good, with 93% patient survival at 5 years post living related transplantation and 87% post cadaveric transplantation. Graft survival is not as good. Again graft survival is best in the living related (75% 5 year survial), with a lower 5 year graft survival following the commoner cadaveric graft of 59%.

Figure 9: Kaplan Meier 1 year end stage renal disease patient survival by modality and year of incidence or transplantation from 1980 to 1990. Starting at day 91 following certification for end-stage renal disease for dialysis patients and censored at first transplant, and at the day of transplant for transplanted patients. Adjusted for age, race, gender, and diagnosis. [AE95]

Comparing outcome based upon mode of renal replacement therapy is difficult due to many factors. A crude analysis is shown in figure  9.

Many analysis would suggest however that it is the patient's health prior to treatment rather than the treatment modality itself that is the most important factor that determines survival.