UK Renal Registry 13th Annual Report (December 2010): Chapter 3: demographic and biochemistry profile of kidney transplant recipients in the UK in 2009: national and centre-specific analyses.

INTRODUCTION

National transplant registries routinely focus on centre-specific patient and graft survival rates following renal transplantation. However other outcomes such as graft function (as measured by eGFR), haemoglobin, biochemical variables and blood pressure are also important quality of care indicators.

METHODS

Renal transplant activity, incident graft survival data and donor information were obtained from NHS Blood and Transplant. Laboratory and clinical variables and prevalent survival data were obtained from the UK Renal Registry. Data were analysed separately for prevalent and one year post-transplant patients.

RESULTS

Increasing live and donor after cardiac death donors were responsible for the increasing transplant activity within the UK. During 2009, 2.9% of prevalent transplant patients experienced graft failure and transplant patient death rates remained stable at 2.5 per 100 patient years. There was centre variation in outcomes including eGFR, haemoglobin and biochemical variables in prevalent and 1 year posttransplant patients. Analysis of prevalent transplants by chronic kidney disease stage showed 14.3% with an eGFR <30 ml/min/1.73 m(2) and 1.9% with an eGFR <15 ml/min/1.73 m(2). Of those with CKD stage 5T, 33.3% had haemoglobin concentrations <10.5 g/dl, 22.4% phosphate concentrations ≥ 1.8 mmol/L and 7.7% adjusted calcium concentrations ≥ 2.6 mmol/L.

CONCLUSION

Significant variations in clinical outcomes (unadjusted for patient-specific variables) amongst kidney transplant recipients continued to exist in the UK, and may reflect differences in healthcare delivery between renal centres.