What is already known about this topic and why is it important?

International differences in patient and graft survival after kidney transplantation may be due to differences in clinical practice and patient population. Previous studies have shown that there are differences in short and long-term patient survival after kidney transplantation between the United States (US) and Canada (1) and between the US and the United Kingdom, Australia and New Zealand (2). Both studies have shown that survival differences increase with time after transplantation with US patients having the worst long term survival (1,2). Another study reported that graft survival among European kidney transplant recipients was superior to US patients, especially for five- and ten- year graft survival (3). In addition, a previous study has shown that in European patients between 2000 and 2015 the relative risk of graft failure after transplantation declined substantially (4). However, the latter two studies were not population based and did not investigate country-specific outcomes within Europe.

Therefore, our aim is to present an overview of short and long-term adult patient and graft survival after the first kidney transplantation in 12 European countries. In addition, we will elaborate on how factors such as the transplant rate and graft survival within a country contribute to the observed differences in patient survival.

How will you carry out your study?

The ERA-EDTA Registry dataset will be used to investigate the patient and graft survival after kidney transplantation by country. The two-, five- and ten-year survival probabilities will be calculated.

How will you decide which patients are included in your study?

We will include adult patients receiving a first kidney transplant between 1/1/2003 and 31/12/2015 in different European countries that provided individual patient data from 2003 onwards. Patients who indicated that their data shouldn’t be used for research will be excluded.

How many patients do you anticipate including?

We anticipate to include about 100.000 patients receiving a first kidney transplant between 2003 and 2015 from the participating countries in Europe.

For how long will you follow up these patients?

Patients will be followed from their first kidney transplantation till death, loss to follow-up or the end of the study period (31 December 2017).

What new information will your study generate and how will this benefit patients?

This study will generate an overview of differences in survival after kidney transplantation between European countries. These results can be used in future studies to investigate differences in clinical practice and patient characteristics that may explain these differences. With this new information we can assist nephrologists to exchange best practice for patients in need of RRT.