title: Significant improvement in patient survival after renal transplantation in the last decade.
abstract: BACKGROUND
  The extremely good results of renal transplantation have favored the use of pre-emptive procedures for treatment of patients with end-stage renal disease before entering dialysis, but still some concerns exist about patient survival. The aim of this study was to analyze the evolution of death rates and the causes of mortality among recipients of procedures performed between 1970 and 2007.
  
  
  METHODS
  We examined the outcomes at 1, 5, 10, and 15 years follow-up of 793 adults who underwent primary or repeat renal transplantation from living or deceased donors between January 1, 1970 and December 31, 2007. To evaluate the impact of immunosuppressive regimens on patient survivals, we considered 3 time intervals: the precyclosporine era, the cyclosporine era, and the postcyclosporine era.
  
  
  RESULTS
  During follow-up 115/793 (14.5%) renal transplant recipients died. There was a significant decrease in the overall mortality rate over the years. Patients who underwent transplantation more recently in the postcyclosporine era (1997-2007) showed a mortality rate of 1.8% (7/394) at 1 year and 3.3% (13/394) at 5 years, significantly lower than in previous periods. There was no significant change in the most frequent causes of death: cardiovascular diseases and sepsis.
  
  
  CONCLUSIONS
  Our data indicated a significant improvement in patient survival after renal transplantation over the last decade. These data are significantly better than those reported for dialysis treatment thus supporting the strategy of pre-emptive transplantation for end-stage renal disease.
authors.affiliation: Department of Surgery, Division of General Surgery and Organ Transplantation, Renal Transplantation Unit, Catholic University, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Favi
authors.forename: M P
authors.initials: MP
authors.lastname: Salerno
authors.forename: J
authors.initials: J
authors.lastname: Romagnoli
authors.forename: M
authors.initials: M
authors.lastname: Castagneto
authors.forename: F
authors.initials: F
authors.lastname: Citterio
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016030:Kidney Transplantation; D012086:Reoperation; D015996:Survival Rate
chemical_list: D007166:Immunosuppressive Agents