Survival Varies by Transplant Type
Bessie Young, MD
PHILADELPHIA—In a system where solid organ transplant recipients have universal access to medications and health care, kidney transplant patients have better survival following transplantation than liver and heart transplant patients, data show.
Moreover, over an average of five years of follow-up, the study revealed no significant differences in mortality between white and minority patients.
The findings are based on a study of 1,332 veterans who received solid organ transplants in the Veterans Affairs health care system. Of these, 443 died over the study's 12-year observation period (1995-2007). The patients who died were more likely to be older, white, and to have had a liver or heart transplant.
“We found that compared to kidney transplants, liver transplant patients had a 60% percent higher mortality risk and heart transplant patients had a 61% higher mortality risk,” said investigator Bessie A. Young, MD, MPH, a nephrologist at the Veterans Affairs Puget Sound Health Care System and associate professor of medicine at the University of Washington in Seattle. Subjects who received transplant between 2000 and 2004 had better survival rates compared with those who received their transplants between 1995 and 1999.
“We were a bit surprised with the results because racial and ethnic differences in survival after transplant are common,” Dr. Young told Renal & Urology News.
“Minority patients who receive all of their transplant medications and treatment within a single system in which there is equal access care may have similar survival compared to white patients. However, this study does have some limitations, such as the relatively small number of transplants and the lack of induction medication [information] and donor information at the time of transplantation.”
As for why kidney transplant patients had better survival than liver and heart recipients, she noted that kidney transplant recipients often have the option to go back on dialysis, where liver and heart recipients have no options. She hypothesized that better medical management and improvements in available medications may have contributed to lower death rates among transplant recipients in more recent years.