More Kidney Transplants Are Failing

Despite medical advances, rate of rejection is rising, study finds

WEDNESDAY, March 10, 2004 (HealthDayNews) -- The rate of kidney transplant failure is on the rise in the United States, says a University of Florida study in the March issue of the American Journal of Transplantation.

Increasingly effective drug regimens have helped doctors cut by half the short-term rejection rates in the months after kidney transplantation. But when the researchers analyzed a U.S. national database on people who received kidney transplants between 1995 and 2000, they found there's been an increase in the odds that a kidney transplant will ultimately fail.

Whether a patient experiences episodes of acute rejection has long been regarded as an important indicator of long-term success or failure of a kidney transplant. It's believed that preventing acute rejection, especially in the year following transplantation, is critical to long-term success.

This study indicates the need for more research to evaluate other factors that might help accurately predict long-term transplantation success.

"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," Dr. Bruce Kaplan, medical director of renal and pancreas transplantation at the university's College of Medicine, says in a prepared statement.

"All the drug trials now are aimed 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," Kaplan says.

He and his colleagues also found that an increasing number of kidney transplant patients who suffered an episode of rejection failed to recover organ function.

"We noted that patients who did experience a rejection were left with more functional deterioration than most patients in the past. 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," Kaplan says.

More information

The American Diabetes Association has more about kidney transplantation.

SOURCE: University of Florida, news release, March 2004
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