How Long Can I Live With a Kidney Transplant?

Curious folks ask me how long I can live with a transplanted kidney.  Assuming no accident occurs to shorten life, I will live longer than the median three years of a dialysis patient but not as long as someone like me but without kidney disease.

According to the United States Renal Data Service (governmental keeper of kidney disease statistics), transplant survival rates vary, depending on whether the kidney came from a deceased or living donor.  The average survival percentages are:

One-Year Survival – Survival is excellent the first year following transplant surgery, with 96 percent of recipients of deceased-donor kidneys and 99 percent of recipients of  living-donor kidneys still living.  This first year can be tough for some, though.  Ten percent suffer an acute rejection episode, which is usually resolved with anti-rejection drug changes.  About 28 percent of non-diabetic transplant recipients require insulin, and 22 percent are hospitalized for congestive heart failure.

 Five-Year Survival – At the end of year five, 85 percent of deceased-donor and 93 percent of living-donor recipients remain alive.  However, 16 percent have been hospitalized during the first two years for urinary tract infections or pneumonia, and 10 percent for a cardiovascular event.  Forty percent have developed new onset diabetes.

At about the third year following transplant, damage to the graft (transplanted kidney) can be seen, caused by the immunosuppressant drugs.  Over 85 percent of transplant patients take tacrolimus (prograf), a calcineurin inhibitor, a drug extremely effective in preventing rejection but harsh on the graft.

Ten-Year Survival – Despite the potential health scares mentioned above, 62 percent of deceased-donor and 78 percent of living-donor recipients are still alive with functioning grafts at 10 years.

For all transplant recipients, cardiovascular disease is the leading cause of death, taking 30 percent of them.  Infections kill 21 percent and cancer another 10 percent, resulting in part from the resistance-lowering effects of the immunosuppressants recipients must take daily.

The survival percentages recited here reflect all transplant recipients, including those with serious coexisting health issues even before surgery.  Many carry excessive weight, are diabetic, have a history of cardiovascular disease, are HIV positive, or have other health issues.  These conditions interfere with survival and drive the overall survival percentages down.

Many transplant recipients are alive with the graft at 25, 30, or more years.  Transplant recipients who follow a healthy diet, such as the DASH diet encouraged by; exercise regularly for heart and vessel health; take precautions to avoid infections; avoid smoking; take prescription drugs as directed; and maintain a healthy weight are likely to enjoy the longest survival with their graft.



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4 Responses to How Long Can I Live With a Kidney Transplant?

  1. Unfortunately graft survival isn’t as simple as indicated above. Factors such as the age of the recipient when transplanted, the underlying diagnosis that required the transplant, as well as the HLA match of the grafted organ*, and the presence or absence of other co-morbidities matter. This is why it’s important to gather as much information as possible for your particular situation and not rely on national averages.

    *The transplant industry likes to downplay it but according to OPTN data, degree of tissue match still matters. Besides, anti-rejection meds carry their own risks, and the better the match, the less meds required (usually).

  2. Vicki says:

    Thank you for your comment to my post. As my post indicated, the survival percentages were for all transplant recipients as reported by the USRDS in its last-published Annual Data Report. As you suggest, the survival projection for an individual recipient is impacted by a host of individual issues. These include age, health status at transplant and later, lifestyle factors (including diet, exercise, weight control, smoking, etc.), concurrent diseases, immunosuppressant drug dosage, to name a few. Future posts we make will focus on these important factors. They also are addressed in the KidneySteps book.

    I very much appreciate your attention on the individual and your reminder that the individual may fall outside the average. Please visit kidneysteps regularly so we continue to benefit from your insights.

  3. anita smith says:

    i am a type 1 diabetic and i have had a kidney transplant for nearly 17 years, my sister gave me her kidney and we were a very good match, i keep fit and healthy now but the first 5 years was the hardest time ever, im now wondering how long my kidney will last

    • Vicki says:

      You question is not easy to answer. Your long-term survival with the graft depends upon numerous factors that have to do with you and your health condition, as well as the graft condition. You say you received the graft from your sister and it was a good match. That gives you a good long-term survival prospect. Depending upon age at donation, a slew of other matching factors,and your health, a graft could survive for decades. Your type 1 diabetes does cause the graft harm, even though you control your blood glucose level. Ask your nephrologist to chart your kidney function to determine how long function might last. That can be done with the several creatinine/estimated GFR readings that you’ve had over the years.