Survival Benefit of Solid-Organ Transplant in the United States

IMPORTANCE The field of transplantation has made tremendous progress since the first successful kidney transplant in 1954. OBJECTIVE To determine the survival benefit of solid-organ transplant as recorded during a 25-year study period in the United Network for Organ Sharing (UNOS) database and the Social Security Administration Death Master File. DESIGN, SETTING, AND PARTICIPANTS In this retrospective analysis of UNOS data for solid-organ transplant during a 25-year period (September 1, 1987, through December 31, 2012), we reviewed the records of 1 112 835 patients: 533 329 recipients who underwent a transplant and 579 506 patients who were placed on the waiting list but did not undergo a transplant. MAIN OUTCOMES AND MEASURES The primary outcome was patient death while on the waiting list or after transplant. Kaplan-Meier survival functions were used for time-to-event analysis. RESULTS We found that 2 270 859 life-years (2 150 200 life-years from the matched analysis) were saved to date during the 25 years of solid-organ transplant. A mean of 4.3 life-years were saved (observed to date) per solid-organ transplant recipient. Kidney transplant saved 1 372 969 life-years; liver transplant, 465 296 life-years; heart transplant, 269 715 life-years; lung transplant, 64 575 life-years; pancreas-kidney transplant, 79 198 life-years; pancreas transplant, 14 903 life-years; and intestine transplant, 4402 life-years. CONCLUSIONS AND RELEVANCE Our analysis demonstrated that more than 2 million life-years were saved to date by solid-organ transplants during a 25-year study period. Transplants should be supported and organ donation encouraged.