In a study believed to be the largest yet conducted in the field of transplantation, researchers found that solid-organ transplantation saved about 2.3 million life-years in the United States over a 25-year period, an accomplishment they called “stellar.”
“These life-years saved are in patients with end-organ failure, who are among the sickest patients,” the investigators wrote in an online report in JAMA Surgery. “Of note, the life-years saved were observed; there are no projections in this analysis.”
In a retrospective study, Abbas Rana, MD, of Baylor College of Medicine in Houston, and colleagues analyzed data from the United Network for Organ Sharing data for solid-organ transplantation from September 1, 1987 through December 13, 2012. They reviewed the records of 1,112,835 patients, including 533,329 who underwent a transplant and 579,506 who were placed on a waiting list but did not undergo a transplant.
The observed number of life-years saved to date was 2,270,859 overall and 1,372,969, 465,296, 269,715, 64,575, 79,198, 14,903, and 4,402 for kidney, liver, heart, lung, pancreas-kidney, pancreas, and intestine recipients, respectively.
Solid-organ transplants saved a mean of 4.3 life-years per solid-organ transplant recipient overall. Kidney, liver, heart, lung, pancreas-kidney, pancreas, and intestine transplants saved a mean of 4.4, 4.3, 4.9, 2.6, 4.6, 2.4, and 2.8 life-years per recipient, respectively.
The median survival time of patients with end-stage renal disease was 12.4 years for those who received a kidney transplant compared with 5.4 years for patients on a waiting list. The study also found a survival advantage for adult kidney transplant recipients of living-donor transplants compared with deceased-donor transplants (median survival time 18.5 years vs. 9.8 years).
“These results refute any lingering perception of transplantation as a niche field with limited practical benefit,” Dr. Rana’s group concluded. “Furthermore, focusing exclusively on the survival benefit does not capture the vast improvements in quality of life and the drastically lowered morbidity rates after a transplant.”
The researchers also observed, “Our analysis indicated that, as a nation, we achieved the peak volume in transplantation in 2006. The critical shortage of donors continues to hamper this field: only 47.9% of patients on the waiting list during the 25-year study period underwent a transplant.”