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 kidneysteps.com; 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.