Kidney Transplantation

Many more people need an organ for transplantation than there are organs available. Once a person with end-stage kidney disease has been evaluated and becomes a candidate for a transplant, he or she is put on a waiting list.

How long the wait for a donor kidney is depends on the urgency of the patient's condition, his or her blood and tissue type, the size of organ needed, how long he or she has been on the waiting list and the availability of a suitable organ.

The table below describes the kidney transplant rate at Cedars-Sinai and factors such as the total amount of time that all transplant candidates at Cedars-Sinai spent on the wait list, how many donor organs became available at Cedars-Sinai and how Cedars-Sinai's transplant rate compares with other kidney transplant centers throughout the nation.

Cedars-Sinai Kidney Transplant Rates	2007	2008	Jun 2008 - Jun 2009
Person years*	445.8	463.0	475.6
Removals for transplant	135	154	146
Transplant rate (per year on wait list)	0.30	0.33	0.31
Expected transplant rate**	0.22	0.19	0.19
How the rates at this center compare to those in the nation?	Statistically higher	Statistically Higher	Statistically Higher

* Person years are calculated as days (converted to fractional years). the number of days from Jan. 1 or from the date of the first waiting listing until death, transplant, removal from the waiting list or Dec. 31.

** The expected transplant rate is adjusted for age, blood type, previous transplantation, time on the waiting list, peak PRA, and the interaction between previous transplantation and peak PRA.

Patient and Graft Survival Rates for Adult Kidney Transplant Patients at Cedars-Sinai

A successful kidney transplant depends on appropriate evaluation of the kidney recipient, expertise in the surgical procedures required to transplant the kidney and on-going monitoring after transplant to prevent kidney rejection or infections.

At Cedars-Sinai Medical Center, one-month, one-year and three-year survival rates are tracked for transplants patients.

In the table below, both the numbers and percentages of kidney transplant patients surviving one month, one year and three years are highlighted.

In addition, survival rates for kidney transplant patients at Cedars-Sinai Medical Center are also compared to survival rates expected for kidney transplant patients with similar ages and health conditions.

The one-month and one-year survival rates reflect patients receiving their first transplant between July 1, 2006, and Dec. 31, 2008. The three-year survival rates reflect patients receiving their first transplant between Jan.1, 2004, and June 30, 2006.

Kidney Transplant * (Adults Age 18+ only)	Cedars-Sinai Medical Center
Patient Survival For:	1 Month	1 Year	3 Years
For transplants performed	Jul 2006 - Dec 2008	Jul 2006 - Dec 2008	Jan 2004 - Jun 2006
Number of transplants	263	263	157
Percent of patients surviving at the end of period observed**	99.62%	95.85%	92.99%
Expected, based on national experience**	99.18%	96.20%	91.90%
Cedars-Sinai's survival rates compared to what is expected for similar patients	Not significantly different	Not significantly different	Not significantly different

* These statistics reflect adults age 18+ who were having their first kidney transplant. They do not include patients who were having other organs transplanted at the same time (a kidney pancreas transplant, for example).

** Observed survival rates use the Kaplan-Meier method to estimate outcomes for patients for whom complete follow-up is not expected. Because different cohorts are followed for each time period, it is possible for the reported three-year survival to exceed one-year survival.

*** The survival rate that would be expected for the patients served by the center, given the characteristic mix of the recipient and donor (age, disease and blood type, etc.) and the experience of similar patients in the United States as a whole.

The data in the first table below refers to transplants in which a person who had passed away provided the donated kidney. The second table refers to transplants in which a living person donated the kidney.

It should be noted that at Cedars-Sinai Medical Center, many of the people receiving a kidney transplanted from a deceased donor are also highly HLA sensitized. Despite this, the number of successful kidney transplants three years after the transplant surgery at Cedars-Sinai is 87.23% compared to 79.94% expected on the basis of national experience.

Kidney Transplant * (Adults Age 18+ only)	Cedars-Sinai Medical Center
Deceased Donor Graft Survival For:	1 Month	1 Year	3 Years
For transplants performed	Jul 2006 - Dec 2008	Jul 2006 - Dec 2008	Jan 2004 - Jun 2006
Number of transplants	178	178	94
Percent of grafts surviving at the end of period observed**	94.38%	89.73%	87.23%
Expected, based on national experience**	96.27%	89.61%	79.94%
Cedars-Sinai's survival rates compared to what is expected for similar patients	Not significantly different	Not significantly different	Not significantly different

Kidney Transplant * (Adults Age 18+ only)	Cedars-Sinai Medical Center
Living Donor Graft Survival For:	1 Month	1 Year	3 Years
For transplants performed	Jul 2006 - Dec 2008	Jul 2006 - Dec 2008	Jan 2004 - Jun 2006
Number of transplants	148	148	105
Percent of grafts surviving at the end of period observed**	97.30%	93.29%	89.52%
Expected, based on national experience**	98.16%	95.64%	88.69%
Cedars-Sinai's survival rates compared to what is expected for similar patients	Not significantly different	Not significantly different	Not significantly different

Patient and Graft Survival Rates for Pediatric Kidney Transplant Patients at Cedars-Sinai

The following table reflects survival rates at the one-month, one-year and three-year points for patients under the age of 18 when they received their first transplant.

Kidney Transplant * (Pediatric Patients Age <18 only)	Cedars-Sinai Medical Center
Patient Survival For:	1 Month	1 Year	3 Years
For transplants performed	Jul 2006 - Dec 2008	Jul 2006 - Dec 2008	Jan 2004 - Jun 2006
Number of transplants	7	7	14
Percent of patients surviving at the end of period observed**	100%	100%	100%

The data in the first table below refers to transplants in which a person who had passed away provided the donated kidney. The second table refers to transplants in which a living person donated the kidney.

Kidney Transplant * (Pediatric Patients <Age 18 only)	Cedars-Sinai Medical Center
Deceased Donor Graft Survival For:	1 Month	1 Year	3 Years
For transplants performed	Jul 2006 - Dec 2008	Jul 2006 - Dec 2008	Jan 2004 - Jun 2006
Number of transplants	7	7	9
Percent of grafts surviving at the end of period observed	100%	100%	100%
Expected, based on national experience***	99.66%	92.91%	86.79%
Cedars-Sinai's survival rates compared to what is expected for similar patients	Not significantly different	Not significantly different	Not significantly different

Kidney Transplant * (Pediatric Patients Age <18 only)	Cedars-Sinai Medical Center
Living Donor Graft Survival For:	1 Month	1 Year	3 Years
For transplants performed	Jul 2006 - Dec 2008	Jul 2006 - Dec 2008	Jan 2004 - Jun 2006
Number of transplants	-	-	7
Percent of patients surviving at the end of period observed	-	-	100%
Expected, based on national experience***	-	-	91.05%
Cedars-Sinai's survival rates compared to what is expected for similar patients	-	-	Not significantly different

* These statistics reflect patients age 18+ who had their first kidney transplant. It does not include multiple organ transplants (such as a kidney and pancreas transplant).

** Observed survival rates use the Kaplan-Meier method to estimate outcomes for patients for whom complete follow-up is not expected. Because different cohorts are followed for each time period, it is possible for the reported three-year survival to exceed one-year survival.