UK National Transplant Database: a digest of published audit material. UKTSSA National Transplant Database.

The analyses undertaken on the national transplant database for the UK and Republic of Ireland on behalf of the participating transplant units have shown some factors influencing survival to be common to all organ types, and an improvement in survival over the last ten years for all organ transplant groups. The increasing use of older donors is also a general problem, despite the differing definition of 'old donors' for each organ group. The main findings from the multifactorial analysis are summarised below, both for those factors influencing 1-year transplant survival, and survival over distinct posttransplant epochs. The number of previous transplants had a significant influence on survival across all organ types. For heart transplants, the effects of recipient sex, age, primary disease and donor cause of death were strongest during the first 28 days, and donor age influenced survival from 29 days onwards. The number of previous transplants was found to be the only influence on heart/lung transplants but for lung(s) transplants, the weight of the recipient was also found to influence survival throughout. Recipient primary disease was found to influence survival in the first 21 days, while donor sex, CMV match and donor cause of death influenced survival over 21 days. The majority of factors influencing liver transplant survival were present in both the first 21 days and beyond. Differences were found between the early and late epochs, with younger recipients influencing early survival, and recipients over age 40 influencing survival after 21 days. Analyses of factors associated with kidney transplant survival have shown significant improvement over time. Retransplantation, and the use of kidneys from older (>55 years), younger (<19 years), and non-trauma victim donors continue to carry significantly higher risks of failure. Female donor to male recipient, exchanged and non-beneficially matched transplants, along with grafts given to younger and older recipients, were also associated with inferior survival. The analysis of 4 distinct posttransplant intervals further confirmed that, for some factors, the risk persisted while, for others, their effect was transient.