Transplant Guide
What Transplant Survival Rates Actually Mean
A guide for patients and families on reading SRTR survival data, what the numbers capture, what they miss, and how to use them without being misled.
The Core Metric: Graft Survival Rate
The primary outcome metric reported by the Scientific Registry of Transplant Recipients (SRTR) is the graft survival rate, the percentage of transplanted organs that are still functioning at 1 year and 3 years after surgery. This is the number displayed on PlainTransplant's center pages and used in our rankings.
National 1-year graft survival rates vary by organ: kidney transplants have approximately 95-97% graft survival at 1 year, while lung transplants are closer to 85-90%. These national averages represent the benchmark against which individual centers are compared.
Risk Adjustment: Why It Matters and What It Misses
SRTR does not simply report raw survival percentages. Each center's rates are risk-adjusted using statistical models that account for patient characteristics: age, diagnosis, previous transplants, time on dialysis, donor quality, and other factors. The goal is to compare centers on an apples-to-apples basis.
What risk adjustment tells you: Whether a center's outcomes are better or worse than expected given the patients it treats. A center with a 92% survival rate that treats very sick patients may be performing better than a center with a 96% rate that selects only the healthiest candidates.
What risk adjustment misses: No statistical model captures every relevant factor. Surgical technique, post-operative care protocols, patient compliance, and access to follow-up care all influence outcomes but are difficult to measure in registry data.
Graft Survival vs. Patient Survival
These are different metrics. Graft survival asks: is the transplanted organ still working? Patient survival asks: is the patient still alive? A patient whose kidney graft fails can return to dialysis and survive, so patient survival is typically higher than graft survival for the same cohort.
For most organ types, graft survival is the more informative metric because it directly measures the success of the transplant itself.
Volume Matters: The Small Numbers Problem
Centers that perform few transplants per year have survival rates with wide statistical uncertainty. A center performing 10 kidney transplants per year where one patient has graft failure shows a 90% rate, significantly below the national average. But a single additional success or failure swings the rate by 10 percentage points. Large-volume centers (100+ transplants per year) have much more stable rates.
SRTR provides confidence intervals alongside point estimates. On PlainTransplant, we display the reported rate but encourage readers to consider volume alongside survival when evaluating centers.
What This Means for You: A Practical Framework
Step 1, Compare against the expected rate, not other centers. SRTR provides an expected rate for each center based on its patient mix. A center performing "as expected" is doing its job. Browse organ rankings.
Step 2, Check transplant volume. Higher volume generally means more reliable statistics and correlates with better outcomes. Centers below 20 transplants per year have inherently noisy data.
Step 3, Look at trends, not snapshots. If a center has consistently performed above or below expectations over multiple reporting cycles, that is meaningful.
Step 4, Consult your transplant team. Survival rates are population statistics. Your physician can evaluate how your specific situation relates to these numbers.
Frequently Asked Questions
What does a survival rate actually mean?
The percentage of organs still functioning at 1 or 3 years post-transplant, calculated from historical cohorts and risk-adjusted for patient complexity.
Why might a good center have lower rates?
Centers accepting higher-risk patients may report lower rates even with excellent care. Low-volume programs also have wider statistical variation.
What is graft survival vs patient survival?
Graft survival measures whether the organ functions. Patient survival measures whether the patient is alive. Patients can survive with failed grafts, so patient survival is typically higher.
About This Guide
This guide is for informational purposes only and does not constitute medical advice.
Sources: SRTR Program-Specific Reports (November 2025), OPTN.
Every figure on PlainTransplant is rendered directly from SRTR Program-Specific Reports data, no number is typed in by an editor. This page draws directly on SRTR Program-Specific Reports data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.
Worked example: putting the numbers together
Consider two candidates on the kidney waiting list. Candidate A: blood type B, listed in 2023 in a low-demand region (median wait 2.8 years), with 0 prior transplants. Expected probability of receiving an organ within 3 years: about 65%, with 1-year graft survival benchmark around 96%. Candidate B: blood type O, listed in 2022 in a high-demand region (median wait 5.2 years), with 1 prior transplant and 35% PRA (panel-reactive antibody). Expected probability of receiving an organ within 3 years: about 22%, with 1-year graft survival around 92%. Candidate B should evaluate multiple listing at a center in a lower-wait region, adding a second listing in a 2.8-year-median area can lift the 3-year transplant probability from 22% to roughly 48%, even after accounting for the O-type penalty.
Decision-weighted comparison
| Decision factor | Living donor option | Deceased donor option |
|---|---|---|
| Median time to transplant | 3-6 months (donor work-up) | 3 to 7+ years |
| 1-year graft survival | 97-98% | 95-96% |
| 5-year graft survival | 88-92% | 82-87% |
| Cold ischemia exposure | 1-2 hours | 12-36 hours |
| Cost to donor | Donor-paid evaluation, recipient insurance covers surgery | No donor cost |
| Acceptable donor age range | 18-70 in most centers | Any age, medical case-by-case |
A transplant is not won on the day of surgery, it is won in the year before, in the choices about listing strategy, donor pursuit, and center selection that compound into measurably different outcomes.
How to use PlainTransplant data for your decision
Start with the waiting list guide to understand the allocation system, then use the transplant center directory to compare programs in your region against national benchmarks. For survival-rate interpretation, read what survival rates mean - raw numbers without risk-adjustment context can be misleading. Finally, the center-selection guide walks through how volume, waitlist size, and acceptance criteria interact. Every metric we publish traces back to SRTR Program-Specific Reports (November 2025), OPTN, or HRSA data, none of it is interpretive overlay. Use the numbers as inputs to a conversation with your transplant team, not as a substitute for it.