Your kidneys are a pair of bean-shaped organs found below your rib cage on either side of your spine. The primary function of your kidneys is to filter waste and extra fluid from your blood to make urine.

A kidney transplant is a procedure to replace an unhealthy kidney with a new kidney from a donor. End stage kidney failure is the most common reason people receive kidney transplants. People with end stage kidney failure need long-term dialysis or a kidney transplant to survive.

Kidney transplants are generally very successful at extending life for people who are eligible. Up to 97% of transplanted kidneys survive for at least 1 year.

There are two types of kidney transplant.

Living-donor kidney transplant (LDKT) is when the kidney comes from a person who is still alive, often a family member of the recipient.

Deceased-donor kidney transplant (DDKT) is when the kidney comes from a person who is deceased.

Keep reading to learn more about the success rates of these two procedures.

The Organ Procurement Transplant Network (OPTN) is a nonprofit that manages the United States organ transplant system. Each year, together with the Scientific Registry of Transplant Recipients (SRTR), the OPTN releases an annual report providing an analysis of organ transplants.

According to the 2020 annual report, 83.9% of LDKT recipients over age 65 are alive 5 years after their transplant. The 5-year survival rate is higher in people ages 18 to 35, at 97.8%. People who had kidney failure due to diabetes had the lowest 5-year survival rate compared to other causes, at 88.3%.

The 5-year survival rates are higher among LDKT recipients than among DDKT recipients of the same age. LDKT recipients also tend to spend less time on dialysis.

The 5-year survival rate for transplanted kidneys is slightly lower than the 5-year survival rate for people who have received a kidney. A total of 81.6% of transplanted kidneys in people over 65, and 90.9% in people ages 35 to 49, survive for at least 5 years.

Success rates for DDKT are high but lower than those for LDKT. More DDKTs are performed each year since there are more deceased donors available. Roughly four times more DDKTs than LDKTs were performed in 2020, according to the OPTN/SRTR 2020 report.

The 5-year survival rate for DDKT is 74.3% in people over 65 and 95.8% in people ages 18 to 34.

As with LDKT, people with kidney failure due to diabetes had the lowest 5-year survival rate, 81.1%.

Despite the high success rates, wait times for kidney transplants are often very long. Of people placed on waiting lists from 2015 to 2017:

  • 34.6% were still waiting after 3 years
  • 25% had undergone a DDKT
  • 14% had undergone an LDKT
  • 6.4% had died
  • 20% had been removed from the list

Many factors, including the following, can affect the success rate of a kidney transplant.

Age

The ages of the donor and the recipient can affect the chances of success. In a 2016 study, researchers found that recipient age was the second leading risk factor for predicting kidney transplant outcomes.

Perhaps counterintuitively, as age increases, so does the predicted survival time — likely because younger people have younger immune systems that can lead to more organ rejections.

In the OPTN/SRTR 2020 report, researchers reported organ rejection in 9.1% of recipients ages 18 to 34 and 5.9% of recipients over 65.

In the 2016 study, the researchers found that donor age was the fourth leading risk factor. Increasing donor age was associated with a higher chance of kidney rejection.

Cold ischemic time

Cold ischemic time is the time between chilling the donated kidney and restoring its blood supply. A shorter duration is associated with higher rates of successful surgery. In the 2016 study, the researchers found that this was the top factor for predicting outcomes.

Creatinine levels at discharge

Creatinine levels give your doctor a good estimation of how well your kidneys are working. In the 2016 study, the researchers found that creatinine levels at hospital discharge were the third most important factor for predicting outcomes.

Duration of hospitalization

The same group of researchers found that the duration of hospitalization was the fifth leading risk factor. Longer-than-typical hospital stays were associated with poorer survival.

Ethnicity

According to the OPTN/SRTR 2020 report, Asian recipients had the highest survival rate and Black recipients had the lowest.

According to 2020 clinical practice guidelines on kidney transplantation, all people with chronic kidney disease who are expected to reach end stage kidney disease should be considered for transplantation.

The guidelines recommend that doctors refer all potential candidates for evaluation at least 6 to 12 months before those people are likely to need dialysis.

The incidence of end stage kidney failure is rapidly increasing. The most common causes are diabetes and high blood pressure.

Each transplant center has its own guidelines for transplants. Some centers may have age restrictions or may not consider you a candidate if you have certain medical conditions.

According to the National Kidney Foundation, factors that might affect candidacy include:

  • recent cancer diagnosis
  • severe heart disease
  • insufficient health to survive the transplant
  • active infection
  • tobacco use or substance misuse
  • obesity

People with end stage kidney failure need to undergo continuous dialysis or a kidney transplant to survive. Kidney transplants have high rates of success and are the preferred treatment for people who are eligible. However, finding an appropriate donor can take years.

Your doctor can help you figure out whether you qualify for a kidney transplant and start the process of applying for a donation.