Long-term renal allograft survival: Have we made significant progress or is it time to rethink our analytic and therapeutic strategies?

Herwig Ulf Meier-Kriesche, Jesse D. Schold, Bruce Kaplan

Research output: Contribution to journalArticle

471 Citations (Scopus)

Abstract

Impressive renal allograft survival improvement between 1988 and 1995 has been described using projections of half-lives based on limited actual follow up. We aimed, now with sufficient follow up available to calculate real half-lives. Real half-lives calculated from Kaplan-Meier curves for the overall population as well as subsets of repeat transplants and African Americans recipients were examined. Real half-lives were substantially shorter than projected half-lives. As a whole, half-lives have improved by about 2 years between 1988 and 1995 as compared to the earlier projected 6 years of improvement. The improvement seems to be driven primarily by the improvement in graft survival of re-transplants. First transplants showed a cumulative increase in graft survival of less than 6 months. Projected half-lives are a risky estimation of long-term survival especially when based on short actual follow up. First-transplant survival has only marginally improved during the early years of post transplant follow up while no significant improvement in long-term survival could be detected between 1988 and 1995. Redirection of attention from early endpoints towards the process of long-term graft loss may be necessary to sustain early gains in the long term.

Original languageEnglish (US)
Pages (from-to)1289-1295
Number of pages7
JournalAmerican Journal of Transplantation
Volume4
Issue number8
DOIs
StatePublished - Aug 2004
Externally publishedYes

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Allografts
Transplants
Kidney
Graft Survival
Therapeutics
African Americans
Population

Keywords

  • Era effect
  • Graft survival
  • Half life
  • Kidney transplantation
  • Long term outcomes
  • Projection

ASJC Scopus subject areas

  • Immunology

Cite this

Long-term renal allograft survival : Have we made significant progress or is it time to rethink our analytic and therapeutic strategies? / Meier-Kriesche, Herwig Ulf; Schold, Jesse D.; Kaplan, Bruce.

In: American Journal of Transplantation, Vol. 4, No. 8, 08.2004, p. 1289-1295.

Research output: Contribution to journalArticle

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