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Trends of kidney transplantation in Japan in 2018: data from the kidney transplant registry
© The Author(s) 2019
- Received: 8 November 2018
- Accepted: 14 January 2019
- Published: 29 January 2019
The number of kidney transplants has gradually increased in the last decade; it was 1742 in Japan in 2017. The outcomes have improved year by year, with the indications for transplantation expanding accordingly. In this paper, we will report the unique trends and outcomes of kidney transplantation in Japan. The detailed transplant characteristics and outcomes are also shown as an updated version of the previous report in the Renal Replacement Therapy. Transplantations in elderly, diabetic, and ABO-incompatible living donors have been more widely performed recently, with the outcomes of these transplants having improved remarkably. However, the number of deceased donor transplants is still quite small, and further efforts to increase deceased organ donation continue to be of utmost necessity in Japan.
- Kidney transplantation
- National registry
We first reported the current status of kidney transplantation in Japan in 2015 as part of the Renal Replacement Therapy . In this article, we describe the latest trends and outcomes of kidney transplantation as observed in 2017 in Japan. This report is based on the data of the annual progress report from the Japanese Renal Transplant Registry, which is published in the Japanese journal “Ishoku” , and the Renal Replacement Therapy . Since 2001, a total of 120–140 centers have performed kidney transplants in Japan . All individual data were collected from the kidney transplant centers via the electronic registry system [1, 2]. The patient and graft survival rates were analyzed using the Kaplan-Meier method.
Number of kidney transplants and transplant centers in Japan
Dialysis therapy before transplantation
ABO blood type incompatibility
The overall patient and graft survival rates, along with the causes of death and graft loss, were analyzed. The rates were analyzed using the Kaplan-Meier method, stratified by the year of transplantation, under timespans such as 1983–2000, 2001–2009, and 2010–2016. In addition, these analyses were stratified by age, diabetes, preemptive, dialysis periods, and ABO blood type incompatibility in living donor transplants performed after 2001.
Preemptive transplants and dialysis
The number of living donor transplants, especially elderly transplants, has increased each year in Japan. Diabetic and preemptive living donor transplantations have also been performed widely in the last decade. In addition, ABO incompatibility has ceased to be a barrier to transplantation, and this type of transplant forms about 30% of living donor transplants now. The patient and graft survival rates have improved according to the time of transplantation, especially in the short term, such as within 5 years after transplantation. Lengthening the survival time is an important issue, particularly in diabetic and/or elderly transplants. Chronic rejection due to antibody-mediated reactions and death with functioning graft is also formidable problems that need to be resolved. The number of deceased donor transplants is still very small, leading to the persistent need for further efforts to increase deceased donation in Japan.
Availability of data and materials
Please contact author for data requests.
Authors who are members of the Kidney Transplant Registry committee carried out the analyses of the data and approved the manuscript.
Ethics approval and consent to participate
All registered data were approved by each transplant center.
Consent for publication
The authors declare that they have no competing interests.
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Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
- Yagisawa T, Mieno M, Yoshimura N, Yuzawa K, Takahara S. Current status of kidney transplantation in Japan in 2015: the data of the Kidney Transplant Registry Committee, Japanese Society for Clinical Renal Transplantation and the Japan Society for Transplantation. Ren Replace Ther. 2016;2:68.View ArticleGoogle Scholar
- Japanese Society for Clinical Renal Transplantation. The Japan Society for Transplantation, annual progress report from the Japanese Renal Transplant Registry: number of renal transplantation in 2017 and follow-up survey. Ishoku (Japanese Journal). 2018;53:89–108 (in Japanese).Google Scholar
- Takahashi K, Yagisawa T, Sonda K, Kawaguchi H, Yamaguchi Y, Toma H, Agishi T, Ota K. ABO-incompatible kidney transplantation in a single-center trial. Transplant Proc. 1993;25:271–3.PubMedGoogle Scholar