Survival benefit of solid-organ transplant in the United States

Importance: The field of transplantation has made tremendous progress since the first successful kidney transplant in 1954. Objective: To determine the survival benefit of solid-organ transplant as recorded during a 25-year study period in the United Network for Organ Sharing (UNOS) database and the Social Security Administration Death Master File. Design, Setting, And Participants: In this retrospective analysis of UNOS data for solid-organ transplant during a 25-year period (September 1, 1987, through December 31, 2012), we reviewed the records of 1 112 835 patients: 533 329 recipients who underwent a transplant and 579 506 patients who were placed on the waiting list but did not undergo a transplant. Main Outcomes And Measures: The primary outcomewas patient death while on the waiting list or after transplant. Kaplan-Meier survival functions were used for time-to-event analysis. Results: We found that 2 270 859 life-years (2 150 200 life-years from the matched analysis) were saved to date during the 25 years of solid-organ transplant. A mean of 4.3 life-years were saved (observed to date) per solid-organ transplant recipient. Kidney transplant saved 1 372 969 life-years; liver transplant, 465 296 life-years; heart transplant, 269 715 life-years; lung transplant, 64 575 life-years; pancreas-kidney transplant, 79 198 life-years; pancreas transplant, 14 903 life-years; and intestine transplant, 4402 life-years. Conclusions And Relevance: Our analysis demonstrated that more than 2 million life-years were saved to date by solid-organ transplants during a 25-year study period. Transplants should be supported and organ donation encouraged.