Outcomes following renal transplantation are usually reported as graft or patient survival. However, graft function, haemoglobin and blood pressure are also important measures of quality of care.
Transplant activity and incident graft survival data were obtained from NHS Blood and Transplant (NHSBT), laboratory and clinical variables and prevalent survival data were obtained from the UK Renal Registry (UKRR). Data were analysed separately for prevalent and one year post-transplant patients.
Increasing live and non-heartbeating donors were responsible for the increasing transplant activity. Transplant waiting list numbers continued to rise by 8%. Graft failure occurred in 3.2% of prevalent transplant patients. Death rates remained stable at 2.3/100 patient years. Malignancy accounted for 21% of these deaths. There was centre variation in outcomes such as eGFR and haemoglobin in prevalent and 1 year post-transplant recipients. Analysis of prevalent transplants by chronic kidney disease stage showed 16% with eGFR <30 and 2.2% <15. Of those in stage 5T, 26% had Hb <10 g/dl, 27% phosphate ≥ 1.8 mmol/L and 50% an iPTH ≥ 32 pmol/L. These patients were less likely to achieve the UK standards in comparison to CKD5 dialysis patients.
Wide variations in clinical and biochemical outcomes may be secondary to variations in the care administered to transplant recipients across the UK.
Rommel Ravanan, UK Renal Registry, Southmead Hospital, Southmead Road, Bristol BS10 5NB, UK, Email: email@example.com
Published online: March 26, 2009
Number of Print Pages : 28
Nephron Clinical Practice
Vol. 111, No. Suppl. 1, Year 2009 (Cover Date: March 2009)
Journal Editor: El Nahas M. (Sheffield)
ISSN: 1660-2110 (Print), eISSN: 1660-2110 (Online)
For additional information: http://www.karger.com/NEC
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