UK Renal Registry 11th Annual Report (December 2008): Chapter 5 Demographics and biochemistry profile of kidney transplant recipients in the UK in 2007: national and centre-specific analyses.

INTRODUCTION Outcomes following renal transplantation are usually reported as graft or patient survival. However, graft function, haemoglobin and blood pressure are also important measures of quality of care. METHODS Transplant activity and incident graft survival data were obtained from NHS Blood and Transplant (NHSBT), laboratory and clinical variables and prevalent survival data were obtained from the UK Renal Registry (UKRR). Data were analysed separately for prevalent and one year post-transplant patients. RESULTS Increasing live and non-heartbeating donors were responsible for the increasing transplant activity. Transplant waiting list numbers continued to rise by 8%. Graft failure occurred in 3.2% of prevalent transplant patients. Death rates remained stable at 2.3/100 patient years. Malignancy accounted for 21% of these deaths. There was centre variation in outcomes such as eGFR and haemoglobin in prevalent and 1 year post-transplant recipients. Analysis of prevalent transplants by chronic kidney disease stage showed 16% with eGFR <30 and 2.2% <15. Of those in stage 5T, 26% had Hb <10 g/dl, 27% phosphate > or = 1.8 mmol/L and 50% an iPTH > or = 32 pmol/L. These patients were less likely to achieve the UK standards in comparison to CKD5 dialysis patients. CONCLUSION Wide variations in clinical and biochemical outcomes may be secondary to variations in the care administered to transplant recipients across the UK.