The graft survival curve: Ideology and rhetoric —Part II

Abstract

In a previous paper entitled “The Graft Survival Curve: Ideology & Rhetoric” [1], I attempted to understand and interpret the significance of the common language and concepts used by members of the transplantation community, with respect to the graft survival statistic and its visual representation, the graft survival curve. In the course of this analysis, it became clear that there were many scientific dimensions as well as possible political agendas in the presentation and promotion of survival statistics and survival curves. First, proper clinical studies and clinical trials use this type of primary or secondary endpoint associated with testing a hypothesis either with retrospective analysis or prospective methodology. Second, the same type of endpoint outcome measure is derived from the voluntary submission of data sent to various local, national and international registries. What became very clear in analyzing the nature of and the statements about graft survival statistics was that they obscurely reflected the continuation of a long-standing confrontation that has been known in the field of clinical transplantation: the battle over control of the rules of organ rationing between the cadres of immunologists and clinicians.