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Survival Benefit of Solid-Organ Transplantation: 10-Year Update

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Abstract

Importance

Transplantation has transformed into a burgeoning field that is rapidly evolving to optimize organ distribution and survival outcomes. The years since 2012 (the last comprehensive study) have seen changes in transplantation, such as advances in immunotherapy and novel indices, that necessitate an updated analysis of survival benefit.

Design

Our goal was to determine the survival benefit for solid-organ transplants in the United Network for Organ Sharing (UNOS) database for a three decade period and provide updates on advancements since 2012. Our retrospective analysis examined data containing U.S. patient records from September 1, 1987, to September 1, 2021.

Results

We found that 3,430,272 life-years were saved over our transplant period (4.33 life-years saved per patient); kidney—1,998,492 life-years; liver -767,414; heart—435,312; lung—116,625; pancreas-kidney—123,463; pancreas—30,575; intestine—7901. After matching, 3,296,851 life-years were saved. Life-years saved and median survival increased for all organs between 2012 and 2021. Compared to 2012, median survival increased in kidney (from 12.4 to 14.76 years), liver (from 11.6 to 14.59), heart (9.5 to 11.73), lung (5.2 to 5.63), pancreas-kidney (from 14.5 to 16.88), pancreas (from 13.3 to 16.10). When compared to 2012, the percent transplanted increased in kidney, liver, heart, lung, and intestine, while pancreas-kidney and pancreas show decreased percent transplanted.

Conclusion

Our study underscores the tremendous survival benefits of solid organ transplantation (over 3.4 million life-years saved) and shows improvements since 2012. Our study also highlights areas of transplantation, notably pancreas transplants, that may necessitate reinvigorated attention.

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Data availability

Liam Ferreira had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

References

  1. Medawar PB. The behaviour and fate of skin autografts and skin homografts in rabbits: a report to teh war wounds committee of the medical research council. J Anat. 1944;78:157–176.

    Google Scholar 

  2. Merrill JP, Murray JE, Harrison JH, Warren R. Successful homoransplantation of the human kidney between identical twins. JAMA - J Am Med Assoc. Published online 1960.

  3. Venuta F, Van Raemdonck D. History of lung transplantation. J Thorac Dis. 2017;9:5458–5471. https://doi.org/10.21037/jtd.2017.11.84.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Lillehei RC, Simmons RL, Najarian JS, et al. Pancreatico-duodenal allotransplantation- experimental and clinical experience. Ann Surg. 1970:1–30. papers://b143513d-fae4-4c9b-a747-0e5cbf61224a/Paper/p2581

  5. Starzl TE, Klintmalm GBG, Iwatsuki S, Fernandez BC. Past and Future prospects of orthoptic liver transplantation. Arch Surg. 1981;116:1342–1343. https://doi.org/10.1001/archsurg.1981.01380220086013.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Barnard CN. What we have learned about heart transplants. J Thorac Cardiovasc Surg 1968;56:457–468. https://doi.org/10.1016/s0022-5223(19)42805-5.

    Article  CAS  PubMed  Google Scholar 

  7. Pilch NA, Bowman LJ, Taber DJ. Immunosuppression trends in solid organ transplantation: The future of individualization, monitoring, and management. Pharmacotherapy. 2021;41:119–131. https://doi.org/10.1002/phar.2481.

    Article  PubMed  Google Scholar 

  8. Rana A, Gruessner A, Agopian VG et al. Survival benefit of solid-organ transplant in the United States. JAMA Surg. 2015;150:252–259. https://doi.org/10.1001/jamasurg.2014.2038.

    Article  PubMed  Google Scholar 

  9. Rao PS, Schaubel DE, Guidinger MK et al. A comprehensive risk quantification score for deceased donor kidneys: The kidney donor risk index. Transplantation. 2009;88:231–236. https://doi.org/10.1097/TP.0b013e3181ac620b.

    Article  PubMed  Google Scholar 

  10. Klair T, Gregg A, Phair J, Kayler LK. Outcomes of adult dual kidney transplants by KDRI in the United States. Am J Transplant. 2013;13:2433–2440. https://doi.org/10.1111/ajt.12383.

    Article  CAS  PubMed  Google Scholar 

  11. Jadlowiec CC, Taner T. Liver transplantation: Current status and challenges. World J Gastroenterol. 2016;22:4438–4445. https://doi.org/10.3748/wjg.v22.i18.4438.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Shah KS, Kittleson MM, Kobashigawa JA. Updates on heart transplantation. Curr Heart Fail Rep. 2019;16:150–156. https://doi.org/10.1007/s11897-019-00432-3.

    Article  PubMed  Google Scholar 

  13. Bos S, Vos R, Van Raemdonck DE, Verleden GM. Survival in adult lung transplantation: where are we in 2020? Curr Opin Organ Transplant. 2020;25:268–273. https://doi.org/10.1097/MOT.0000000000000753.

    Article  PubMed  Google Scholar 

  14. Egan TM, Edwards LB. Effect of the lung allocation score on lung transplantation in the United States. J Hear Lung Transplant. 2016;35:433–439. https://doi.org/10.1016/j.healun.2016.01.010.

    Article  Google Scholar 

  15. Stratta RJ, Fridell JA, Gruessner AC, Odorico JS, Gruessner RWG. Pancreas transplantation: A decade of decline. Curr Opin Organ Transplant. 2016;21:386–392. https://doi.org/10.1097/MOT.0000000000000319.

    Article  Google Scholar 

  16. Singh TP, Milliren CE, Almond CS, Graham D. Survival benefit from transplantation in patients listed for heart transplantation in the United States. J Am Coll Cardiol. 2014;63:1169–1178. https://doi.org/10.1016/j.jacc.2013.11.045.

    Article  PubMed  Google Scholar 

  17. Coemans M, Süsal C, Döhler B et al. Analyses of the short- and long-term graft survival after kidney transplantation in Europe between 1986 and 2015. Kidney Int. 2018;94:964–973. https://doi.org/10.1016/j.kint.2018.05.018.

    Article  PubMed  Google Scholar 

  18. Augustine J. Kidney transplant: New opportunities and challenges. Cleve Clin J Med. 2018;85:138–144. https://doi.org/10.3949/ccjm.85gr.18001.

    Article  Google Scholar 

  19. Hariharan S, Israni AK, Danovitch G. Long-term survival after kidney transplantation. N Engl J Med. 2021;385:729–743. https://doi.org/10.1056/nejmra2014530.

    Article  CAS  PubMed  Google Scholar 

  20. Stewart DE, Kucheryavaya AY, Klassen DK, Turgeon NA, Formica RN, Aeder MI. Changes in deceased donor kidney transplantation one year after KAS implementation. Am J Transplant. 2016;16:1834–1847. https://doi.org/10.1111/ajt.13770.

    Article  CAS  PubMed  Google Scholar 

  21. Heemann U, Oberbauer R, Sprangers B, Gökalp C, Bemelman F. Deceased donor kidney allocation schemes and international exchange. Curr Opin Organ Transplant. 2020;25:66–73. https://doi.org/10.1097/MOT.0000000000000720.

    Article  PubMed  Google Scholar 

  22. Song ATW, Avelino-Silva VI, Pecora RAA, Pugliese V, D’Albuquerque LAC, Abdala E. Liver transplantation: Fifty years of experience. World J Gastroenterol. 2014;20:5363–5374. https://doi.org/10.3748/wjg.v20.i18.5363.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Toniutto P, Zanetto A, Ferrarese A, Burra P. Current challenges and future directions for liver transplantation. Liver Int. 2017;37:317–327. https://doi.org/10.1111/liv.13255.

    Article  PubMed  Google Scholar 

  24. Bodzin AS, Baker TB. Liver transplantation today: Where we are now and where we are going. Liver Transplant. 2018;24:1470–1475. https://doi.org/10.1002/lt.25320.

    Article  Google Scholar 

  25. Thabut G, Mal H. Outcomes after lung transplantation. J Thorac Dis. 2017;9:2684–2691. https://doi.org/10.21037/jtd.2017.07.85.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Finger EB, Radosevich DM, Dunn TB et al. A composite risk model for predicting technical failure in pancreas transplantation. Am J Transplant. 2013;13:1840–1849. https://doi.org/10.1111/ajt.12269.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Gruessner AC, Gruessner RWG. Pancreas transplantation of US and Non-US cases from 2005 to 2014 as reported to the United network for organ sharing (UNOS) and the international pancreas transplant registry (IPTR). Rev Diabet Stud. 2016;13:35–58. https://doi.org/10.1900/RDS.2016.13.35.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Fridell JA, Niederhaus S, Curry M, Urban R, Fox A, Odorico J. The survival advantage of pancreas after kidney transplant. Am J Transplant. 2019;19:823–830. https://doi.org/10.1111/ajt.15106.

    Article  PubMed  Google Scholar 

  29. Shingde R, Calisa V, Craig JC et al. Relative survival and quality of life benefits of pancreas–kidney transplantation, deceased kidney transplantation and dialysis in type 1 diabetes mellitus—a probabilistic simulation model. Transpl Int. 2020;33:1393–1404. https://doi.org/10.1111/tri.13679.

    Article  PubMed  Google Scholar 

  30. Esmeijer K, Hoogeveen EK, Van Den Boog PJM et al. Superior long-term survival for simultaneous pancreas-kidney transplantation as renal replacement therapy: 30-year follow-up of a nationwide cohort. Diabetes Care. 2020;43:321–328. https://doi.org/10.2337/dc19-1580.

    Article  PubMed  Google Scholar 

  31. Lentine KL, Alhamad T, Cheungpasitporn W et al. Impact of functional status on outcomes of simultaneous pancreas-kidney transplantation: Risks and opportunities for patient benefit. Transplant Direct:. 2020. https://doi.org/10.1097/TXD.0000000000001043.

    Article  PubMed  Google Scholar 

  32. Kubal CA, Mangus RS, Tector AJ. Intestine and multivisceral transplantation: current status and future directions. Curr Gastroenterol Rep. 2015. https://doi.org/10.1007/s11894-014-0427-8.

    Article  PubMed  Google Scholar 

  33. Celik N, Stanley K, Rudolph J et al. Improvements in intestine transplantation. Semin Pediatr Surg. 2018;27:267–272. https://doi.org/10.1053/j.sempedsurg.2018.07.001.

    Article  PubMed  Google Scholar 

  34. Sudan D. The current state of intestine transplantation: Indications, techniques, outcomes and challenges. Am J Transplant. 2014;14:1976–1984. https://doi.org/10.1111/ajt.12812.

    Article  CAS  PubMed  Google Scholar 

  35. Grant D, Abu-Elmagd K, Mazariegos G et al. Intestinal transplant registry report: Global activity and trends. Am J Transplant. 2015;15:210–219. https://doi.org/10.1111/ajt.12979.

    Article  CAS  PubMed  Google Scholar 

  36. Garcia J, Selvaggi G, Tekin A, Vianna R. Intestinal transplantation. Curr Opin Organ Transplant. 2021;26:229–233. https://doi.org/10.1097/MOT.0000000000000865.

    Article  Google Scholar 

  37. Avitzur Y, Wang JY, De Silva NT et al. Impact of intestinal rehabilitation program and its innovative therapies on the outcome of intestinal transplant candidates. J Pediatr Gastroenterol Nutr. 2015;61:18–23. https://doi.org/10.1097/MPG.0000000000000735.

    Article  PubMed  Google Scholar 

  38. Foster MC, Varothai N, Weiner DE. Estimation of life-years saved by solid-organ transplant. JAMA Surg. 2015;150:1015. https://doi.org/10.1001/jamasurg.2015.1936.

    Article  PubMed  Google Scholar 

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Funding

This research did not receive any specific grant funding from agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Student Affairs, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA

    Liam D. Ferreira, Cameron Goff, Spoorthi Kamepalli, Ashley E. Montgomery & John James Miggins

  2. Division of Abdominal Transplantation, Department of General Surgery, Liver Center, Baylor College of Medicine, Houston, TX, USA

    John A. Goss

  3. Division of Abdominal Transplantation, Michael E DeBakey Department of General Surgery, Baylor College of Medicine, Houston, TX, USA

    Abbas Rana

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  1. Liam D. Ferreira
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Contributions

Concept and Study Design—LDF, AR; Acquisition, analysis and interpretation of data—LDF, CG, AR; Writing the manuscript—LDF, CG, AR, SK, AEM, JJM, JAG; Critical revision—LDF, AR.

Corresponding author

Correspondence to Liam D. Ferreira.

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Conflict of interest

The authors of this manuscript have no conflicts of interest to disclose.

Ethical approval

Institutional review board approval was obtained for this retrospective study, and informed consent was waived. All patient information is deidentified from the public database United Network for Organ Sharing.

Informed consent

Since this study was a retrospective chart review, informed consent was waived. All personally identifiable data was removed.

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Ferreira, L.D., Goff, C., Kamepalli, S. et al. Survival Benefit of Solid-Organ Transplantation: 10-Year Update. Dig Dis Sci 68, 3810–3817 (2023). https://doi.org/10.1007/s10620-023-08012-1

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