Kidney Transplant

Choosing a Kidney and Pancreas Transplant Program

Patient Survival Rates

The most important information to look for is the one-year and three-year patient and graft survival rates of each individual program. However, it is also important to make sure that the patient follow-up is adequate so that the results are representative of the program. A good kidney transplant center should have:

• One year and three year patient survival rates of 95 percent and 90 percent (the national average is 95 percent and 90 percent).
• Deceased donor graft survival rates at one and three years should be 90 percent and 80 percent (the national average is 89 percent and 78 percent).
• Live donor graft survival rates at one and three years should be 95 percent and 88 percent (the national average is 94 percent and 88 percent).

It should be noted that some centers transplant patients who are considered higher risk than others and that this needs to be considered in evaluating patient and graft survival rates from individual programs.

Pancreas transplants are usually performed in patients with kidney failure brought about by complications related to diabetes. One year patient survival rates should range from 94 to 97 percent. One year graft survival rates should range from 79 to 86 percent.

Data can be found at the following independent organization Web sites:

• United Network for Organ Sharing www.unos.org
• ustransplant.org: Scientific Registry of Transplant Recipients www.ustransplant.org

For information about Mayo Clinic's kidney transplant survival rates, see Volumes and Statistics.

History of the Program

It is helpful to know how long the program has been in existence and how long it has been performing kidney and pancreas transplants. Larger programs with a sustained history of excellence are likely to be more stable over time. It is also helpful to know if a program has been continuously active for a number of years, since some programs will have a short period of activity, followed by a lull as personnel move on to other institutions.

Some pertinent information to find out would be:

• First Kidney Disease Specialist (nephrologist)
• First Kidney Transplant
• Total number of Transplants
• Activity over last three years

Contributions to the Field

Centers that contribute to new ideas and research in the field of kidney disease and diabetes and kidney and pancreas transplantation generally have personnel who are in touch with the latest therapies and techniques. Patients can benefit by seeking the most up-to-date treatment options.

• New Medical Therapies
• New Surgical Therapies

Ask to see if new and evolving therapies are offered at the center, especially ones that may pertain to a particular disease. Some centers participate in protocols funded by the National Institutes of Health (NIH) which, in general, must meet rigorous criteria in order to be approved. Others participate in pharmaceutical company-sponsored research protocols which are designed to test new medications and treatments.

Patients will have to decide if participating in a trial or protocol is for them. Some patients are comfortable doing so and others are not. However, if a program participates in these types of studies, it generally means they are active in research and are interested in keeping up with the best and newest techniques available for care.

Areas of Research

Programs will have different areas of special expertise. It is very helpful to meet the people who have a special interest in your disease, so you can get an idea of what experience they may have and what they can offer that another center cannot.

Credentials of Personnel

Credentialing has been established for all medical personnel, including:

• ASN (American Society of Nephrologists) certification for nephrologists
• AST (American Society of Transplantation) certification for nephrologists
• Training at approved American Society for Transplant Surgeons (ASTS) programs for surgeons

Determining the experience of nephrologists and transplant surgeons is best accomplished by asking them how long they have worked in the field and how many transplants they have done. Experienced nephrologists have usually worked at least three years after their fellowship training, while experienced transplant surgeons have done at least 100 kidney transplants after completing their fellowship training.