ERA 2025 - Findings from an international target trial emulation show no survival benefit in deceased donor kidney transplantation compared to continuing dialysis.

Dr Rachel Hellemans (Antwerp University Hospital, Antwerp, BE) and Dr Vianda Stel (Amsterdam University Medical Center, Amsterdam, NL) join us to discuss an international target trial emulation exploring the margins of survival benefit in patients undergoing deceased donor kidney transplantation. The trial emulation used ERA registry data on dialysis and kidney transplantations as well as collecting extra data on donor quality.

Findings showed deceased donor kidney transplantation has a two to three times higher risk of death in the first month post-transplant compared to continuing dialysis. Although a substantial survival benefit is seen with young donor kidney transplantation, even in patients who are older, have diabetes or prior history of CV disease, patients over 70 years old who are transplanted with older kidneys have little or no survival benefit compared to continuing dialysis.

Interview Questions:

1. What are the current unmet needs in deceased donor kidney transplantation, and what is the importance behind the target trial emulation?
2. What was the study design and patient population?
3. What were the key findings?
4. What are the take-home messages for practice?

Recorded on-site at ERA in Vienna, 2025.

Editors: Jordan Rance, Yazmin Sadik
Videographers: Tom Green, Dan Brent, David Ben-Harosh

Support: This is an independent interview produced by Radcliffe CVRM.