The American Journal of Transplantation this month is reporting on a University of Florida study finding that the kidney transplant failure rate is rising in the United States.
According to the report, nephrologists have cut short-term rejection rates in half by focusing on short-term anti-rejection drug regimens. But when University of Florida researchers studied kidney transplant recipients who received organs between 1995 and 2000, they found a rising rate of long-term rejections. This new research contradicts the long-held belief that prevention of acute rejection is critical to long-term success of kidney transplants.
From the University of Florida media release:
“All the therapies we use are aimed at decreasing acute rejection, with the assumption that if you decrease acute rejection you’re going to improve outcome,” said Dr. Bruce Kaplan, medical director of renal and pancreas transplantation at UF’s College of Medicine. “All the drug trials now are aiming at lower and lower acute rejection rates with the idea that over a period of time if you decrease rejection you’re going to get better long-term outcome. What we see, at least from this paper, is it’s not a given.”
“The achievement of ever-lower rejection rates does not necessarily lead to improved organ survival,” Kaplan added. “Despite the advances, we’re in a period where we’ve hit a pace of no improvement statistically in kidney survival and in patient survival. We looked at medical records from 1995 to 2000, a period of time no one had really looked at, and saw acute rejection rates had gone done [sic] by 50 percent. The corollary should be of course that outcomes were getting much better or at least a little bit better. But what happened during that period of time is outcomes did not get better and were actually statistically significantly worse in some groups.”
To make matters worse, the Florida study also found evidence that more patients than ever are failing to recover organ function after a rejection episode.
“We noted that patients who did experience a rejection were left with more functional deterioration than most patients in the past,” Kaplan said. “Of those who had a rejection in 1995, 70 percent returned to their previous function. By 2000, only about 40 percent returned to their previous status. So the nature of rejection may be changing as well.”
The University of Florida study analyzed data from more than 62,000 adult transplant patients between 1995 and 2000.
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