Converting Kidney Transplant Survival Rates to Mortality Rates
Direct Conversion Formula
Mortality rate = 100% minus survival rate at each time point. This straightforward mathematical conversion applies to both living-donor and deceased-donor kidney transplant recipients 1.
Living-Donor Kidney Transplant Mortality Rates
Based on international benchmarks, the mortality rates for living-donor kidney transplants are:
- 1-year mortality: 0–5% (derived from 95–100% survival) 2, 1
- 5-year mortality: 10–22% (derived from 78–90% survival) 2, 1
- 10-year mortality: approximately 39% (derived from 61% survival) 2, 1
The research literature confirms these figures, with one Iranian study reporting 5-year survival of 90% for living-related donors (thus 10% mortality) and 88% for living-unrelated donors (thus 12% mortality) 3.
Deceased-Donor Kidney Transplant Mortality Rates
For deceased-donor kidney transplants, mortality rates are:
- 1-year mortality: approximately 5% (derived from 95% survival in comparative studies) 4
- 5-year mortality: 17% for liver transplants (derived from 83% survival for kidneys in comparative analyses) 3
- 5-year mortality: 15–30% for deceased-donor liver transplants (derived from 70–85.5% survival) 2
Important Caveats When Interpreting These Conversions
These mortality rates represent all-cause mortality, not graft-specific failure. The distinction matters because patients can die with a functioning transplant from unrelated causes 2. Guidelines emphasize measuring both patient survival (alive versus dead) and graft survival (functioning transplant) as separate quality indicators 2.
The time period for measurement significantly impacts the calculated mortality rate. Studies use varying follow-up intervals (1-year, 3-year, 5-year, 10-year), and mortality accumulates over time 2, 1. Comparing mortality rates requires matching time periods exactly.
Death-censored graft failure differs from mortality. When a patient dies with a functioning kidney, this counts toward mortality but not toward death-censored graft failure 5. Modern quality metrics separate these outcomes to better understand transplant-specific versus patient-specific factors 2.
Clinical Context for These Mortality Figures
Living-donor transplants consistently demonstrate superior patient survival compared to deceased-donor transplants across all time intervals 2, 1, 3. The 5-year mortality difference ranges from 5–12 percentage points favoring living donors 3, 4.
Contemporary deceased-donor outcomes have improved substantially, with some recent studies showing comparable graft survival between living and deceased donors despite higher delayed graft function rates in deceased-donor recipients 6, 5. However, patient mortality remains consistently lower with living-donor transplants 1, 3.