Baltzan: Renal transplantation in Saskatchewan [CMAJ

Renal transplantation in Saskatchewan

CMAJ 2000;163(2):159

Colin Geddes and Carl Cardella recently reported that the main problems in renal transplantation are the limited supply of donor organs and the failure to improve long-term graft survival rates [Review].¹ The Saskatchewan Transplant Group reported recent evidence for a more optimistic view of these problems in 2 presentations at the 2000 annual meeting of the Canadian Society of Transplantation.

First, the group reported that in each of the past 3 years, the supply of organs has exceeded demand in Saskatchewan; as a result, the waiting list for renal transplantation has been reduced by 25% and the mean waiting time for a graft for recipients without a high plasma reactive antibody titer is now 4 months.² These results have been achieved by increasing the emphasis on donations from living donors and enhancing awareness of the need for organs in intensive care units.

Second, the group reported that while its 5-year graft survival rate did not change between 1984 and 1995, it has dramatically improved since 1995: with cadaveric donors the 5-year graft survival rate is now 84% and with living donors it is 94%, despite a marked increase in the number of zero-haplotype matches in the latter group.³ This has come about because of an 80–90% decrease in the failure rate from chronic allograft nephropathy in postgraft years 1–5 to 1% per year. The reasons for this are not clear, but circumstantial evidence suggests that one factor might be the increased use of angiotensin-converting-enzyme inhibitors, which are known to favourably influence chronic nephropathy in other causes of renal disease such as diabetes.

Marc A. Baltzan
R.F. Dyck
Nephrologists
Saskatoon, Sask.

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Reference

Geddes CC, Cardella CJ. Report card on renal transplantation. CMAJ 2000;162(4):539-40.
Baltzan MA, Shoker AS, Boechler B, Keindel I, Dyck RF. Renal transplantation in Saskatchewan: Does supply satisfy demand? [abstract]. Abstracts of the annual scientific meeting of the Canadian Society of Transplantation; 2000 Mar 1–4; Mont-Tremblant (Que.). Ottawa: The Society; 2000.
Baltzan MA Sr, Abraham D, Shoker AS, Dyck RF, Baltzan MA Jr. Evidence for a recent decrease in chronic progressive renal allograft failure rates [abstract]. Abstracts of the annual scientific meeting of the Canadian Society of Transplantation; 2000 Mar 1–4; Mont-Tremblant (Que.). Ottawa: The Society; 2000.