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Graft Half-Life Living vs Deceased — ESENeph MCQ

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EasyTransplantationGraft Half-Life Living vs DeceasedESENeph

A kidney transplant recipient asks about the expected lifespan of his kidney transplant. He received a living donor kidney from his wife. What is the current expected graft half-life?

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Correct answer: B — Living donor kidney graft half-life is approximately 15-20 years (improving with modern immunosuppression); deceased donor graft half-life is approximately 10-15 years; these are averages and individual outcomes vary widely

Kidney graft survival has improved significantly with modern immunosuppression. Current estimated graft half-lives (time to 50% graft loss): living donor ~15-20 years; deceased donor (standard criteria) ~10-15 years; expanded criteria donor ~8-12 years. One-year graft survival is now >95% for living donor and >90% for deceased donor. The main causes of late graft loss are: chronic antibody-mediated rejection (most common), death with functioning graft, recurrent disease, and chronic CNI nephrotoxicity. Adherence to immunosuppression is the most important modifiable factor for long-term graft survival.

Reference: NHSBT Annual Report 2023; Hart et al 2021 – OPTN Data