With the advance of medicine and better understanding of everything related to transplantation, more patients live longer than ever after transplantation these days. Drugs are better, patient management is more efficient and over the years more and more people have received an organ transplant. The main problem with patients living longer is they may eventually need a kidney transplant. Their native kidneys have been relentlessly exposed to drugs that are hard on them. The transplant drugs, especially prograf and cyclosporine are nephrotoxics and can cause chronic kidney disease in the long run.
For some post transplant patients, a kidney transplant is the only alternative to dialysis. Some may ask themselves if it is worth it and if their prognosis will be good. There are some data available but they are kind of limited because the overall number of kidney transplant after any other transplant is not that elevated. Here is what I found as far as number of transplant on a yearly basis from 1998 to 2007. These include living and deceased donors with an average of 16,000 kidney transplants every year:
- Every year about 10-12% of all kidney transplants are performed on patients that have already received an organ transplant in the past including kidney which represent about 1800 surgeries
- About 2-3% from the above percentage have previously received non-kidney transplant and that means around 350 patients a year.
Those 350 patients include all previous heart, liver, lung, pancreas, intestine transplants who end up having a kidney transplant on a yearly basis. This is a very small pool of transplant recipients to have accurate statistics on. The good is that the survival rate one year after kidney transplant is pretty similar to the first timer. The survival rate is at about 95-96%. Of course there are plenty of variables like age, diagnosis, race, type of kidney (living or deceased donor).
We only see a small dip in the graft (organ) survival and it is only about the graft like it says. What that means is the new kidney may have failed or stopped working after transplant but it does not say if patient is alive or dead. That is most likely due to rejection. When an organ like a kidney fails, more than likely the patient is still alive. A heart, lung or liver that fails is a lot worst because those organs are a lot more important than a kidney and a kidney can be replaced by dialysis. There is no temporary replacement for the other organs. It is retransplant or death unfortunately.So let’s come back to graft survival for kidney transplant. The graft survival is about 2-3 percent lower when the kidney transplant follows any other organ transplant no matter how many years later. We are talking about 94% instead of 96% after one year, so this is a very small difference.
Based on those statistics kidney transplant seems to be a good alternative after any other organ transplant. The challenge is to find a donor since the average wait time is 2-4 years. This is a long time on dialysis! That does not include the 3-4 months the evaluation period takes. The alternative is to have a family member or friend willing to be a Someone can live with one kidney without any problem.