HealthGrades published a list of transplant hospitals with the best track record for survival and chances of receiving a donor organ. HealthGrades annual evaluation of the nation's top-performing hospitals in organ transplantation includes clinical quality data, based on patient outcomes, for each of the 210 adult acute care hospitals that perform transplants. This information is available free to the public and is intended to help patients in need of kidney, lung, heart or liver transplants.

Hospitals with transplant programs received HealthGrades Transplant Excellence Awards if they had a statistically significantly higher three-year survival rate. Award recipients were also required to have waitlist mortality that was either not significantly different than expected or was significantly lower than expected.

HealthGrades Kidney Transplant Excellence Award recognized 11 recipients out the hospitals evaluated: 

• Sutter General Hospital
• UC Davis Medical Center
• Yale - New Haven Hospital
• Tampa General Hospital
• MCG Health Medical Center
• Clarian Methodist Hospital
• Ochsner Clinic Foundation
• Boston Medical Center Corporation
• New York - Presbyterian/Weill Cornell
• Allegheny General Hospital
• University of Washington Medical Center
  
   

Cancer is the second most frequent cause of death in renal transplant recipients, according to a new Dutch study. Researchers analyzed the outcomes of 12,805 patients who received 15,227 kidney transplants between March 1966 and May 2008. Invasive cancer developed in 908 patients (7.1 percent). Of the 3,173 of the patients who died with a functioning transplanted kidney, 510 (16.1 percent) died from cancer. The only other diagnosis that caused more deaths was cardiovascular disease.

Other major causes of death in patients who died with a functioning transplant were infection and gastrointestinal complications. Mortality due to cancer was observed at a significantly later time after transplantation than mortality due to other main complications. Early minimization of immunosuppressants could therefore be successful in the prevention of the late complication of cancer after kidney transplantation.

Kidney transplants that show a combination of fibrosis (scarring) and inflammation after one year are at higher risk of long-term transplant failure, according to a study in the Journal of the American Society of Nephrology (JASN). To identify these abnormalities, doctors would need to perform routine biopsies on apparently normal kidney transplants-rather than waiting for problems to occur. Even for some transplants that would be expected to have a very long graft survival, protocol biopsies performed in the first year may indicate the kidney is undergoing damaging inflammation, which is associated with increased risk for reduced function and graft survival.

The researchers analyzed factors related to transplant survival in 151 patients who had no apparent problems after living-donor kidney transplantation. One-year biopsies showed no abnormalities in 57 percent of kidneys; another 30 percent had fibrosis (scarring) but no inflammation. In these two groups, the transplanted kidney continued to function normally from one to five years' follow-up. However, in the remaining 13 percent of transplants, the biopsies showed fibrosis plus inflammation. These transplants had declining kidney function and a reduced long-term survival rate. Kidneys showing fibrosis plus inflammation also had increased numbers of immune cells as well as a "rejection-like" gene expression signature. Thus, in apparently normal kidney transplants, biopsies showing fibrosis and inflammation signal kidney damage and an increased risk of long-term failure.

Ethnicity is a contributing risk factor of cardiovascular problems in kidney recipients of South Asian origin post-transplant, according to a study in the Clinical Journal of the American Society of Nephrology. South Asians comprise 25 percent of all Canadian visible minorities and have a higher risk for cardiovascular disease in the general population. However, the risk of cardiovascular events has never been studied in this minority population.

Researchers studied 864 kidney recipients. The identified risk factors included ethnicity associated with major cardiac events (MACE) within and beyond 3 months post-transplant. They found no difference among the patients pre-transplant. However, the post-transplant MACE event rate was more than twice as high in South Asians, as in Caucasians, blacks, and East Asians. Heart disease is the number one killer in kidney transplant patients. Traditional risk factors (age, high blood pressure, diabetes, smoking, and high cholesterol) do not fully explain the increased risk. The research indicates that South Asians require their own category in all U.S. transplant and dialysis registry studies, along with Caucasians, blacks, Hispanics, East Asians, and Native Americans.