Ten-year Outcomes of Kidney Transplants at the Singapore General Hospital

Renal transplantation is the treatment of choice for kidney failure. This study analyses the outcomes of kidney transplant recipients whose transplant was performed at the Singapore General Hospital from January 2000 to 31 December 2010, and who have had at least a year of follow-up in the hospital. Patient demographics, recipient and donor characteristics, graft and patient outcomes were extracted from patients' electronic and hard copy medical records. Graft and patient survival were calculated by Kaplan-Meier analysis until return to dialysis or patient death. There are 332 deceased donor (DD) and 118 live donor (LD) kidney transplants included in this study. Majority of our transplant recipients were Chinese males, and the most common etiology of renal failure was chronic glomerulonephritis. DD recipients were significantly older than LD recipients (45.3+ 8.2 years vs. 36.9+ 11.7 years, respectively, P < 0.001), and also had a significantly longer duration of dialysis (8.6+ 2.6 years vs. 2.3+ 3.5 years, respectively, P < 0.001). Majority were on haemodialysis prior to transplantation. DD were significantly older than LD (45.7+ 8.2 years vs. 37.1+ 11.8 years, respectively, P < 0.001); 73.2% of our DD were standard criteria donors. Graft survival at 5 years was 80.8% and 96.5%, and 65.9% and 79.4% at 10 years for DD and LD transplants, respectively. Patient survival at 5 years was 91.5% and 82.7%, and 99.1% and 84.7% at 10 years for DD and LD transplants, respectively. LD recipients had improved graft and patient survival compared to DD recipients, reinforcing LD kidney transplantation as the treatment of choice for patients with end-stage renal failure.