Kidney transplant outcomes have increased steadily over the past 20 years as advances in immunosuppressive medications and our ability to diagnose and treat rejection and infections has improved. It is now not uncommon for kidney transplants to last 17 years on average or longer for live donor organs, abortion and 12 years or longer for deceased donor organs. One of the longest surviving kidney transplants is over 36 years old.
Many factors influence the long term survival of the kidney transplant including: donor factors, healing technical factors, ailment recipient factors and recurrent insults to the graft in the long term.
Donor factors that are most important are donor age, and kidney function. These are relatively fixed and form the baseline from which the remainder of the transplant processes will act.
Technical factors represent those issue raised during organ procurement, storage and implantation of the organ and may relate to complications encountered during these stages of transplantation which may result in suboptimal outcomes.
Recipient factors can include the type of kidney disease which the recipient was originally diagnosed with as this may recur in the new transplant and eventually cause its demise, or ongoing cell mediated- or antibody mediated- rejection, recurrent bladder and kidney infections, noncompliance with medications, bladder outlet obstruction, dehydration and immunosuppressive toxicity. While most of these events can be treated, they generally do leave their mark on the kidney, and with each bit of injury, the kidney loses some of its long term potential.