OPTN/SRTR 2018 Annual Data Report: Kidney Hart, A.; Smith, J. M.; Skeans, M. A. ...
American journal of transplantation,
January 2020, 2020-01-00, 20200101, Letnik:
20, Številka:
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Despite the ongoing severe mismatch between organ need and supply, data from 2018 revealed some promising trends. For the fourth year in a row, the number of patients waiting for a kidney transplant ...in the US declined and numbers of both deceased and living donor kidney transplants increased. These encouraging trends are tempered by ongoing challenges, such as a large proportion of listed patients with dialysis time longer than 5 years. The proportion of candidates aged 65 years or older continued to rise, and the proportion undergoing transplant within 5 years of listing continued to vary dramatically nationwide, from 10% to nearly 80% across donation service areas. Increasing trends in the recovery of organs from hepatitis C positive donors and donors with anoxic brain injury warrant ongoing monitoring, as does the ongoing discard of nearly 20% of recovered organs. While the number of living donor transplants increased, racial disparities persisted in the proportion of living versus deceased donors. Strikingly, the total number of kidney transplant recipients alive with a functioning graft is on track to pass 250,000 in the next 1‐2 years. The total number of pediatric kidney transplants remained steady at 756 in 2018. Deeply concerning to the pediatric community is the persistently low level of living donor kidney transplants, representing only 36.2% in 2018.
OPTN/SRTR 2016 Annual Data Report: Kidney Hart, A.; Smith, J. M.; Skeans, M. A. ...
American journal of transplantation,
January 2018, 2018-01-00, 20180101, Letnik:
18, Številka:
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Data from 2016 show ongoing positive trends in short‐ and long‐term allograft survival, and a decrease in the number of active listed candi‐ dates for the first time in more than a decade, with a ...concomitant in‐ crease in deceased donor kidney transplants. Transplant rates that had changed dramatically for some groups after implementation of the new kidney allocation system in 2014 are stabilizing, allowing for evaluation of new steady states and trends. Many challenges remain in adult kid‐ ney transplantation, including stagnant rates of living donor transplant, geographic disparities in access to transplant, racial disparities in living donor transplant, and overall a continuing demand for kidneys that far outpaces the supply. For pediatric recipients, a decline in the proportion of living donor transplants is of concern. In 2016, only 34.2% of pediatric transplants were from living donors, compared with 47.2% in 2005. The number of related donors decreased dramatically over the past decade, and the number of unrelated directed transplants performed in pediatric candidates remained low (50).
OPTN/SRTR 2017 Annual Data Report: Kidney Hart, A.; Smith, J. M.; Skeans, M. A. ...
American journal of transplantation,
February 2019, 2019-02-00, 20190201, Letnik:
19, Številka:
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Many positive trends in kidney transplantation were notable in 2017. Deceased donor kidney transplant rates and counts continued to rise, the kidney transplant waiting list declined for the third ...year in a row after decades of growth, and both short‐ and long‐term allograft survival continued to improve year over year. In total, more than 220,000 patients were living in the United States with a functioning allograft. With 3 years of data available since implementation of the new kidney allocation system, better prediction of longer‐term results of the allocation policy changes became possible. The data also reveal several areas in need of improvement and attention. Overall, the challenge of providing adequate access to kidney transplant persisted nationally, with additional dramatic regional variation. The proportion of living donor kidney transplants in both adults and children continued to fall, and racial disparities in living donor kidney transplant grew in the past decade.
OPTN/SRTR 2016 Annual Data Report: Liver Kim, W. R.; Lake, J. R.; Smith, J. M. ...
American journal of transplantation,
January 2018, 2018-01-00, 20180101, Letnik:
18, Številka:
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Data on adult liver transplants performed in the US in 2016 are no‐table for (1) the largest total number of transplants performed (7841); (2) the shortest median waiting time in recent history (11.3 ...months); (3) continued reduction in waitlist registrations and transplants for hepatitis C‐related indications; (4) increasing numbers of patients whose clinical profiles are consistent with non‐alcoholic fatty liver disease; and (5) equilibration of transplant rates in patients with and without hepatocellular carcinoma. Despite the increase in the number of available organs, waitlist mortality remained an important concern. Graft survival rates continued to improve. In 2016, 723 new active candidates were added to the pediatric liver transplant waiting list, down from a peak of 826 in 2005. The number of prevalent candidates (on the list on December 31 of the given year) was stable, 408 active and 169 inactive. The number of pediatric living donor liver transplants decreased from a peak of 79 in 2015 to 62 in 2016, with most from donors closely related to the recipients. Graft survival continued to improve over the past decade among recipients of deceased donor and living donor livers.
OPTN/SRTR 2020 Annual Data Report: Liver Kwong, A. J.; Ebel, N. H.; Kim, W. R. ...
American journal of transplantation,
March 2022, 2022-03-00, 20220301, Letnik:
22, Številka:
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This year was marked by the COVID‐19 pandemic, which altered transplant program activity and affected waitlist and transplant outcomes. Still, 8906 liver transplants were performed, an all‐time high, ...across 142 centers in the United States, and pretransplant as well as graft and patient survival metrics, continued to improve. Living donation activity decreased after several years of growth. As of June 30, 2020, 98989 liver transplant recipients were alive with a functioning graft, and in the context of increasing liver transplant volume, the size of both the adult and pediatric liver transplant waitlists have decreased. On February 4, 2020, shortly before the pandemic began, a new liver distribution policy based on acuity circles was implemented, replacing donor service area‐ and region‐based boundaries. A policy change to direct pediatric livers to pediatric recipients led to an increase in deceased donor transplant rates and a decrease in pretransplant mortality rate among children, although the absolute number of pediatric transplants did not increase in 2020. Among adults, alcohol‐associated liver disease became the predominant indication for liver transplant in 2020. After implementation of the National Liver Review Board and lower waitlist priority for most exception cases in 2019, fewer liver transplants were being performed via exception points, and the transplant rate between those with and without hepatocellular carcinoma has equalized. Women continue to experience higher pretransplant mortality and lower rates of liver transplant than men.
OPTN/SRTR 2020 Annual Data Report: Heart Colvin, M.; Smith, J. M.; Ahn, Y. ...
American journal of transplantation,
March 2022, 2022-03-00, 20220301, Letnik:
22, Številka:
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As we enter the third year of the new adult heart allocation policy, we are faced with the new challenges of the COVID‐19 pandemic. In 2020, new listings (adult and pediatric) decreased slightly, ...with 4000 new listings in 2020, compared with 4087 in 2019; however, the number of adult heart transplants performed continued to increase, to 3715 in 2020. The number of pediatric heart transplants declined from 509 in 2019 to 465 in 2020. One‐year and six‐month posttransplant mortality rates in adult recipients have increased slightly since 2015 but have not significantly changed over the past decade. Overall, posttransplant mortality rates for adult recipients were 7.4% at six months and 9.4% at one year for transplants in 2019, 14.0% at three years for transplants in 2017, and 19.1% at five years for transplants in 2015. Although shorter‐term posttransplant mortality rates have slightly increased, there has been a steady downward trend in longer‐term mortality. Mortality rates for pediatric recipients were 5.7% at six months and 8.1% at one year for transplants in 2019, 11.6% at three years for transplants in 2017, and 15.2% at five years for transplants in 2015.
OPTN/SRTR 2019 Annual Data Report: Liver Kwong, A. J.; Kim, W. R.; Lake, J. R. ...
American journal of transplantation,
February 2021, 2021-02-00, 20210201, Letnik:
21, Številka:
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Journal Article
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This year was notable for changes to exception points determined by the geographic median allocation Model for End‐Stage Liver Disease (MELD) and implementation of the National Liver Review Board, ...which took place on May 14, 2019. The national acuity circle liver distribution policy was also implemented but reverted to donor service area‐ and region‐based boundaries after 1 week. In 2019, growth continued in the number of new waiting list registrations (12,767) and transplants performed (8,896), including living‐donor transplants (524). Compared with 2018, living‐donor liver transplants increased 31%. Women continued to have a lower deceaseddonor transplant rate and a higher pretransplant mortality rate than men. The median waiting time for candidates with a MELD of 15‐34 decreased, while the number of transplants performed for patients with exception points decreased. These changes may have been related to the policy changes that took effect in May 2019, which increased waiting list priority for candidates without exception status. Hepatitis C continued to decline as an indication for liver transplant, as the proportion of liver transplant recipients with alcohol‐related liver disease and clinical profiles consistent with non‐alcoholic steatohepatitis increased. Graft and patient survival have improved despite changing recipient demographics including older age, higher MELD, and higher prevalence of obesity and diabetes.
OPTN/SRTR 2018 Annual Data Report: Heart Colvin, M.; Smith, J. M.; Hadley, N. ...
American journal of transplantation,
January 2020, 2020-01-00, 20200101, Letnik:
20, Številka:
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Journal Article
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The new adult heart allocation policy was approved in 2016 and implemented in October 2018, so its effect was not yet evident in 2018 data. However, the more granular data being collected are ...anticipated to allow for improved analyses. In 2018, new listings continued to increase; 3883 new adult and 685 new pediatric candidates were added. In 2018, 3440 heart transplants were performed, an increase of 167 over 2017; 473 transplants occurred in pediatric recipients and 2967 in adult recipients. Short‐term and long‐term posttransplant mortality improved. Overall 1‐year survival for adults who underwent heart transplant in 2011‐2013 was 90.3%, 3‐year survival was 84.7%, and 5‐year survival was 79.6%. Mortality rates for pediatric recipients were 4.5% at 6 months and in 5.9% at 1 year posttransplant, 12.5% at 3 years for transplants in 2014‐2015, 14.8% at 5 years for transplants in 2012‐2013, and 29.8% at 10 years for transplants performed in 2008‐2009.
OPTN/SRTR 2018 Annual Data Report: Liver Kwong, A.; Kim, W. R.; Lake, J. R. ...
American journal of transplantation,
January 2020, 2020-01-00, 20200101, Letnik:
20, Številka:
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Journal Article
Recenzirano
Odprti dostop
Data on adult liver transplants performed in the US in 2018 are notable for (1) continued growth in numbers of new waitlist registrants (11,844) and transplants performed (8250); (2) continued ...increase in the transplant rate (54.5 per 100 waitlist‐years); (3) a precipitous decline in waitlist registrations and transplants for hepatitis‐C‐related indications; (4) increases in waitlist registrants and recipients with alcoholic liver disease and with clinical profiles consistent with non‐alcoholic fatty liver disease; (5) increased use of hepatitis C virus antibody‐positive donor livers; and (6) continued improvement in graft survival despite changing recipient characteristics such as older age and higher rates of obesity and diabetes. Variability in transplant rates remained by candidate race, hepatocellular carcinoma status, urgency status, and geography. The volume of pediatric liver transplants was relatively unchanged. The highest rate of pre‐transplant mortality persisted for children aged younger than 1 year. Children underwent transplant at higher acuity than in the past, as evidenced by higher model for end‐stage liver disease/pediatric end‐stage liver disease scores and listings at status 1A and 1B at transplant. Despite higher illness severity scores at transplant, pediatric graft and patient survival posttransplant have improved over time.
OPTN/SRTR 2019 Annual Data Report: Lung Valapour, M.; Lehr, C. J.; Skeans, M. A. ...
American journal of transplantation,
February 2021, 2021-02-00, 20210201, Letnik:
21, Številka:
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Journal Article
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The number of lung transplants performed continues to increase annually and reached an all‐time high in 2019, with decreasing waitlist mortality. These trends are attributable to an increasing number ...of candidates listed for transplant each year and a continuing increase in the number of donors. Despite these favorable trends, 6.4% of lungs recovered for transplant were not transplanted in 2019, and strategies to optimize use of these available organs may reduce the number of waitlist even further. Time to transplant continued to decrease, as over 50% of candidates waited 3 months or less in 2019, yet regional heterogeneity remained despite policy changes intended to improve allocation equity. Small gains continued in posttransplant survival, with 1‐year survival at 88.8%; 3 year, 74.4%; 5 year, 59.2%, and 10 year, 33.1 %.
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