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 language | English (US) |
---|---|
Pages (from-to) | 1289-1295 |
Number of pages | 7 |
Journal | American Journal of Transplantation |
Volume | 4 |
Issue number | 8 |
DOIs | |
State | Published - Aug 2004 |
Externally published | Yes |
Keywords
- Era effect
- Graft survival
- Half life
- Kidney transplantation
- Long term outcomes
- Projection
ASJC Scopus subject areas
- Immunology and Allergy
- Transplantation
- Pharmacology (medical)