National Kidney Foundation Survey Reveals Major Challenges in Transplantation

Chicago, IL
May 18, 1999

Advances in transplantation science have revolutionized the field of transplantation over the past two decades and offered hope to countless patients. Yet, a new surgeon and physician poll asserts that major challenges – particularly a condition called chronic rejection – remain and must be addressed.

According to the survey of 96 transplant physicians and 77 transplant surgeons, nearly all those polled (92 percent) believe it is essential that better solutions are developed to address chronic rejection, thus making it one of the foremost issues facing the transplant community. The findings of the Unmet Medical Needs In Transplantation survey, developed by the National Kidney Foundation (NKF), were announced today at the 18th Annual Meeting of the American Society of Transplantation (AST).

Improvements Needed to Extend Organ Survival
The survey data reemphasizes the National Institute of Allergy and Infectious Diseases' (NIAID) assertion that long-term transplant survival is no better today than it was 20 years ago. In April 1998, a NIAID expert panel issued recommendations that included a strong endorsement for the development of new therapeutic approaches to prevent chronic rejection.

Indeed, the vast majority of physicians and surgeons surveyed (72 percent) believe chronic rejection is the area in which improvement is most "critically important." The closest followers were graft dysfunction (35 percent), and nephrotoxicity (23 percent).

"Each of these areas present troubling challenges that must be addressed because they not only reduce long-term organ survival but in the process, compromise the health and viability of the transplanted organ," says Dr. Sylvester Sterioff, NKF board member.

Approximately 10 percent of kidney transplants fail each year due to chronic rejection, graft dysfunction and nephrotoxicity, causing the patient to need dialysis and often a new organ.

Patient adherence with immunosuppressive therapy, which was also highlighted in the survey, is another key factor and also contributes to transplant failures that occur within two years after surgery. Approximately 86 percent of those polled agreed that financial barriers, such as insurance coverage, is the most important reason for patient noncompliance.

"We are committed to helping alleviate the financial burden faced by some transplant recipients. The Immunosuppressive Medications Act, of which the NKF is a leading supporter, would extend Medicare coverage of post-operative medications so that precious organs aren't lost due to a lack of insurance coverage," says Dr. Sterioff.

Pre-Operative Obstacles Also Troubling
While the data confirmed that challenges exist in the post-operative phase, issues from the pre-transplantation stage also emerged from the survey. Although 97 percent of those polled ranked surgical techniques "the highest," the majority considered organ procurement practices, including public education about organ donation and recruitment, between "less than good" and "poor."

"We've made great strides in the field of transplantation, but this survey demonstrates that there are significant issues, both in the pre-operative and post-operative phases, that must be addressed to advance the science and care of patients," comments Dr. Sterioff.

The NKF Unmet Medical Needs in Transplantation Survey, an opinion study based on the views of transplant physicians and surgeons, was conducted by Southeastern Institute of Research, a leader in medical community polling. The survey was funded by an educational grant from Wyeth-Ayerst Pharmaceuticals and is the first phase of a three-year study to address unmet needs in transplantation.

The National Kidney Foundation is dedicated to preventing kidney and urinary tract diseases, improving the health and well-being of individuals and families affected by these diseases and increasing the availability of all organs for transplantation.