Kidney Survival Better Across the Pond

Kidney transplants last longer in Europe than in the United States

(RxWiki News) Kidney transplants can save the lives of patients with kidney failure. Unfortunately, patients' bodies do not always accept the new organ.

Kidney transplants in Europe appear to be more successful over the long-term than kidney transplants in the United States, according to recent findings.

"Keep taking your Rx after kidney transplantation."

While the findings showed that 1-year transplant survival rates were the same on either side of the Atlantic, the 5- and 10-year survival rates were significantly better in Europe. In other words, more kidney transplants were rejected in the U.S. than in Europe.

The study - which was conducted by Dr. Adam Gondos, of the German Cancer Research Center, and colleagues - is the first to show the large gap in kidney transplant survival between the U.S. and Europe.

One explanation for the poorer survival rates in the U.S. may be the cost of anti-rejection drugs. In the U.S., Medicare pays back the cost of anti-rejection drugs for only 3 years. American transplant recipients often have to pay out of pocket for these drugs - which can amount to about $20,000 a year.

In Europe, on the other hand, most health insurance pays back the cost of these drugs for life.

From their study, Dr. Gondos and colleagues found that the kidney transplant survival rate after 1 year was 90 percent in both Europe and the U.S. After 5 years, however, the survival rate was 77 percent in Europe and 71 percent among white Americans.

Hispanic Americans had a 5-year donor kidney survival rate of 73 percent while African Americans had a 5-year survival rate of 62 percent.

After 10 years, the European transplant survival rate was 56 percent, compared to 46 percent among white Americans, 48 percent among Hispanic Americans and 34 percent among African Americans.

These findings showed that kidney transplant rejection may be a particularly big problem among African American patients.

The study could not explain the causes of the differences in survival rates between the U.S. and Europe, said Dr. Gondos.

However, the fact that survival rates were similar in the first year but became worse over time may suggest that the differences may be due to post-transplant care and access to anti-rejection drugs, he said.

"It's certainly a thought-provoking study, but I think it's important to remember there are significant differences in the population in Europe versus here in the U.S.," said Laurie Reece, Executive Director of the Texas Transplantation Society.

"Still, it's troubling, and I believe one of the things that should be looked at is the provision of anti-rejection drugs. It's short-sighted of us here for Medicare to cover the cost of a kidney transplant and then not pay for the immunosuppressants after 36 months. If patients lack insurance coverage or the funds to pay for the medications, then they do often lose their transplant and Medicare will then incur the cost of dialysis and possibly another transplant," said Reece, who was not involved in the study.

For their study, the researchers looked at data from 23,500 kidney transplants in Europe and 32,000 kidney transplants in the U.S.

The study was published October 10 in Transplantation, the official journal of the Transplantation Society.

Review Date: 
October 12, 2012