Trends in kidney transplantation rate across Europe: study from the ERA Registry

Abstract

Background The aim of this study was to identify trends in total, deceased donor and living donor kidney transplantation (KT) rates in European countries. Methods The European Renal Association (ERA) Registry and the Global Observatory on Donation and Transplantation (GODT) databases were used to obtain the number of KTs in individual European countries between 2010 and 2018. General population counts were obtained from Eurostat or the national bureaus of statistics. The KT rate per million population (pmp) and the average annual percentage change (APC) were calculated. Results The total KT rate in the 40 participating countries increased with 1.9% annually (95% confidence interval (CI): 1.5, 2.2) from 29.6 pmp in 2010 to 34.7 pmp in 2018, reflecting an increase of 3.4 pmp in the deceased donor KT rate (from 21.6 pmp to 25.0 pmp, APC: 1.9% [95%CI: 1.3, 2.4]) and of 1.5 pmp in the living donor KT rate (from 8.1 pmp to 9.6 pmp, APC: 1.6% [95%CI: 1.0, 2.3]). The trends in KT rate varied widely across European countries. An East-West gradient was observed for deceased donor KT rate with Western European countries performing more KTs. In addition, most countries performed less living donor KTs. In 2018, Spain had the highest deceased donor KT rate (64.6 pmp) and Turkey the highest living donor KT rate (37.0 pmp). Conclusions The total KT rate increased due to a rise in the KT rate from deceased donors and to a lesser extent from living donors, with large differences between individual European countries.

Factors influencing kidney transplantation rates: a study from the ERA Registry

“…The KT rate for the period 2010–2018 was available for all European countries except for Andorra, Liechtenstein, Luxembourg, Monaco, Republic of Kosovo, San Marino, Ukraine and Vatican City [ 16 ]. For the Republic of Moldova, no expert was found, leaving 39 countries (Table 1 and Supplementary Figure SB1 ).…”

“…The aim of this study was to investigate which factors may explain the trends in the total, deceased donor and living donor KT rates across European countries over the last decade that are described in an accompanying article [ 16 ]. The present study may assist countries in learning from each other's experiences on what measures may or may not work in attempts to increase KT rates.…”

International comparison and time trends of first kidney transplant recipient characteristics across Europe: an ERA Registry study

“…Kidney transplantation is the preferred kidney replacement therapy (KRT) in terms of survival and quality of life for end-stage kidney disease (ESKD) patients compared with dialysis [ 1 ]. Large differences exist in the kidney transplantation rate across Europe [ 2 ]. For most countries the kidney transplantation rate has increased over the last decade [ 2 ].…”

Sixty years of European Renal Association (ERA) Registry data on kidney disease: visualizing differences in clinical practice

“…Several other ERA Registry studies show disparities across countries and/or changes in trends over time on for example the incidence of KRT [ 6 ], kidney transplant rates [ 7 ], characteristics of first kidney transplant patients [ 8 ], and trends in KRT survival [ 6 ]. Other studies focused on patient subgroups [ 9 , 10 ].…”

“…Many ERA Registry articles aimed at understanding the reasons for the differences in the epidemiology of KRT. For example, the study on trends in kidney transplant rates [ 7 ] was combined with information on potentially successful measures and perceived barriers that may guide in determining strategies to increase kidney transplant rates [ 16 ]. Another study aimed at understanding the decrease in the incidence of KRT in elderly patients in the Netherlands in comparison with other European countries [ 12 ].…”