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Author Topic: OPTN/SRTR 2012 Annual Data Report: Deceased Organ Donation  (Read 4410 times)

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Offline Clark

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OPTN/SRTR 2012 Annual Data Report: Deceased Organ Donation
« on: December 28, 2013, 05:32:34 PM »
http://onlinelibrary.wiley.com/doi/10.1111/ajt.12585/abstract

OPTN/SRTR 2012 Annual Data Report: Deceased Organ Donation
A. K. Israni1,2,3, D. Zaun1, J. D. Rosendale4,5, J. J. Snyder1,2, B. L. Kasiske1,3
Article first published online: 28 DEC 2013
DOI: 10.1111/ajt.12585
American Journal of Transplantation
Volume 14, Issue s1, pages 167–183, January 2014

ABSTRACT
The status of deceased organ donation is assessed using several metrics, including donation/conversion rate (how often at least one organ is recovered for transplant from an eligible death), organ yield (ratio of observed/expected numbers of organs transplanted), and rate of organs discarded (number of organs discarded divided by the number of organs recovered for transplant). The 2012 donation/conversion rate was 72.5. eligible donors per 100 eligible deaths, slightly lower than the 2011 rate but higher than in previous years. The 2011-2012 yield ratio varied by donation service area from 0.91 (fewer organs transplanted per donor than expected) to 1.09 (more than expected), and also varied for specific organs. The mean number of organs transplanted per donor in 2012 was 3.02, lower than in 2011 and 2010; this number varied by donation service area from 2.04 to 3.76. The number of organs discarded is calculated by subtracting the number of organs transplanted from the number recovered for transplant; this number is used to calculate the discard rate. The discard rate in 2012 for all organs combined was 0.14 per recovered organ, slightly higher than in 2011 and 2011; it varied by donation service area and organ type.
Unrelated directed kidney donor in 2003, recipient and I both well.
620 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
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Offline Clark

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OPTN/SRTR 2012 Annual Data Report: Lung
« Reply #1 on: December 28, 2013, 05:34:16 PM »
http://onlinelibrary.wiley.com/doi/10.1111/ajt.12584/abstract

OPTN/SRTR 2012 Annual Data Report: Lung
M. Valapour1,2, M. A. Skeans1, B. M. Heubner1, J. M. Smith1,3, M. A. Schnitzler1,4, M. I. Hertz1,2, L. B. Edwards4,5, J. J. Snyder1,6, A. K. Israni1,6,7, B. L. Kasiske1,7
Article first published online: 28 DEC 2013
DOI: 10.1111/ajt.12584
American Journal of Transplantation
Volume 14, Issue s1, pages 139–165, January 2014

ABSTRACT
Lung transplants are increasingly used as treatment for end-stage lung diseases not amenable to other medical and surgical therapies. Lungs are allocated to adult and adolescent transplant candidates on the basis of age, geography, blood type compatibility, and the Lung Allocation Score, which reflects risk of wait-list mortality and probability of posttransplant survival. The overall median waiting time in 2012 was 4 months, and 65.3% of candidates underwent transplant within 1 year of listing; however, this proportion varied greatly by donation service area. Unadjusted median survival of lung transplant recipients was 5.3 years in 2012, and median survival conditional on living for 1 year posttransplant was 6.7 years. Among pediatric lung candidates in 2012, 32.1% were wait-listed for less than 1 year, 17.9% for 1 to less than 2 years, 16.7% for 2 to less than 4 years, and 33.3% for 4 or more years. Both graft and patient survival have continued to improve; survival rates for recipients aged 6-11 years are better than for younger recipients. Compared with recipients of other solid organ transplants, lung transplant recipients experienced the highest rates of rehospitalization for transplant complications: 43.7 per 100 patients in year 1 and 36.0 in year 2.
Unrelated directed kidney donor in 2003, recipient and I both well.
620 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
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Offline Clark

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OPTN/SRTR 2012 Annual Data Report: Pancreas
« Reply #2 on: December 28, 2013, 05:40:33 PM »
http://onlinelibrary.wiley.com/doi/10.1111/ajt.12580/abstract

OPTN/SRTR 2012 Annual Data Report: Pancreas
A. K. Israni1,2,3, M. A. Skeans1, S. K. Gustafson1, M. A. Schnitzler1,4, J. L. Wainright5,6, R. J. Carrico5,6, K. H. Tyler5,6, L. A. Kades5,6, R. Kandaswamy1,7, J. J. Snyder1,2, B. L. Kasiske1,3
Article first published online: 28 DEC 2013
DOI: 10.1111/ajt.12580
American Journal of Transplantation
Volume 14, Issue s1, pages 45–68, January 2014

ABSTRACT
The number of pancreas transplants has decreased over the past decade, most notably numbers of pancreas after kidney (pak) and pancreas transplant alone (pta) procedures. This decrease may be mitigated in the future when changes to national pancreas allocation policy approved by the Organ Procurement and Transplantation Network Board of Directors in 2010 are implemented. The new policy will combine waiting lists for pak, pta, and simultaneous pancreas-kidney (spk) transplants), and give equal priority to candidates for all three procedures. This policy change may also eliminate geographic variation in waiting times caused by geographic differences in allocation policy. Deceased donor pancreas donation rates have been declining since 2005, and the donation rate remains low. The outcomes of pancreas grafts are difficult to describe due to lack of a uniform definition of graft failure in the transplant community. However long-term survival is better for spk versus pak and pta transplants. This may represent the difficulty of detecting rejection in the absence of a simultaneously transplanted kidney. The challenges of pancreas transplant are reflected in high rates of rehospitalization, most occurring within the first 6 months posttransplant. Pancreas transplant is associated with higher incidence of rejection compared with kidney transplant.
Unrelated directed kidney donor in 2003, recipient and I both well.
620 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
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OPTN/SRTR 2012 Annual Data Report: Liver
« Reply #3 on: December 28, 2013, 05:43:12 PM »
http://onlinelibrary.wiley.com/doi/10.1111/ajt.12581/abstract

OPTN/SRTR 2012 Annual Data Report: Liver

W. R. Kim1,2, J. M. Smith1,3, M. A. Skeans1, D. P. Schladt1, M. A. Schnitzler1,4, E. B. Edwards5,6, A. M. Harper5,6, J. L. Wainright5,6, J. J. Snyder1,8, A. K. Israni1,8, B. L. Kasiske1
Article first published online: 28 DEC 2013
DOI: 10.1111/ajt.12581
American Journal of Transplantation
Volume 14, Issue s1, pages 69–96, January 2014

ABSTRACT
Liver transplant in the us remains a successful life-saving procedure for patients with irreversible liver disease. In 2012, 6256 adult liver transplants were performed, and more than 65,000 people were living with a transplanted liver. The number of adults who registered on the liver transplant waiting list decreased for the first time since 2002; 10,143 candidates were added, compared with 10,359 in 2011. However, the median waiting time for active wait-listed adult candidates increased, as did the number of candidates removed from the list because they were too sick to undergo transplant. The overall deceased donor transplant rate decreased to 42.3 per 100 patient-years, and varied geographically from 18.9 to 228.0 per 100 patient-years. Graft survival continues to improve, especially for donation after circulatory death livers. The number of new active pediatric candidates added to the waiting list also decreased. Almost 75% of pediatric candidates listed in 2009 underwent transplant within 3 years; the 2012 rate of deceased donor transplants among active pediatric wait-listed candidates was 136 per 100 patient-years. Graft survival for deceased donor pediatric transplants was 92.8% at 30 days. Medicare paid for some or all of the care for more than 30% of liver transplants in 2010.
Unrelated directed kidney donor in 2003, recipient and I both well.
620 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
Proud grandpa!

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OPTN/SRTR 2012 Annual Data Report: Kidney
« Reply #4 on: December 28, 2013, 05:48:17 PM »
http://onlinelibrary.wiley.com/doi/10.1111/ajt.12579/abstract

OPTN/SRTR 2012 Annual Data Report: Kidney

A. J. Matas1,2, J. M. Smith1,3, M. A. Skeans1, B. Thompson1, S. K. Gustafson1, M. A. Schnitzler1,4, D. E. Stewart5,6, W. S. Cherikh5,6, J. L. Wainright5,6, J. J. Snyder1,7, A. K. Israni1,7,8, B. L. Kasiske1,8
Article first published online: 28 DEC 2013
DOI: 10.1111/ajt.12579
American Journal of Transplantation
Volume 14, Issue s1, pages 11–44, January 2014

ABSTRACT
For most end-stage renal disease patients, successful kidney transplant provides substantially longer survival and better quality of life than dialysis, and preemptive transplant is associated with better outcomes than transplants occurring after dialysis initiation. However, kidney transplant numbers in the us have not changed for a decade. Since 2004, the total number of candidates on the waiting list has increased annually. Median time to transplant for wait-listed adult patients increased from 2.7 years in 1998 to 4.2 years in 2008. The discard rate of deceased donor kidneys has also increased, and the annual number of living donor transplants has decreased. The number of pediatric transplants peaked at 899 in 2005, and has remained steady at approximately 750 over the past 3 years; 40.9% of pediatric candidates undergo transplant within 1 year of wait-listing. Graft survival continues to improve for both adult and pediatric recipients. Kidney transplant is one of the most cost-effective surgical interventions; however, average reimbursement for recipients with primary Medicare coverage from transplant through 1 year posttransplant was comparable to the 1-year cost of care for a dialysis patient. Rates of rehospitalization are high in the first year posttransplant; annual costs after the first year are lower.
Unrelated directed kidney donor in 2003, recipient and I both well.
620 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
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Offline Clark

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OPTN/SRTR 2012 Annual Data Report: Heart
« Reply #5 on: December 28, 2013, 05:50:51 PM »
http://onlinelibrary.wiley.com/doi/10.1111/ajt.12583/abstract

OPTN/SRTR 2012 Annual Data Report: Heart

M. Colvin-Adams1,2, J. M. Smithy1,3, B. M. Heubner1, M. A. Skeans1, L. B. Edwards4,5, C. Waller4,5, M. A. Schnitzler1,6, J. J. Snyder1,6, A. K. Israni1,6,7, B. L. Kasiske1,7
Article first published online: 28 DEC 2013
DOI: 10.1111/ajt.12583
American Journal of Transplantation
Volume 14, Issue s1, pages 113–138, January 2014

ABSTRACT
The number of heart transplants performed annually continues to increase gradually, and the number of adult candidates on the waiting list increased by 25% from 2004 to 2012. The heart transplant rate among active adult candidates peaked at 149 per 100 wait-list years in 2007 and has been declining since; in 2012, the rate was 93 heart transplants per 100 active wait-list years. Increased waiting times do not appear to be correlated with an overall increase in wait-list mortality. Since 2007, the proportion of patients on life support before transplant increased from 48.6% to 62.7% in 2012. Medical urgency categories have become less distinct, with most patients listed in higher urgency categories. Approximately 500 pediatric candidates are added to the waiting list each year; the number of transplants performed each year increased from 274 in 1998 to 372 in 2012. Graft survival in pediatric recipients continues to improve; 5-year graft survival for transplants performed in 2007 was 78.5%. Medicare paid for some or all of the care for nearly 40% of heart transplant recipients in 2010. Heart transplant appears to be more expensive than ventricular assist devices for managing end-stage heart failure, but is more effective and likely more cost-effective.
Unrelated directed kidney donor in 2003, recipient and I both well.
620 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
Proud grandpa!

Offline Clark

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OPTN/SRTR 2012 Annual Data Report: Intestine
« Reply #6 on: December 28, 2013, 05:52:16 PM »
http://onlinelibrary.wiley.com/doi/10.1111/ajt.12582/abstract

OPTN/SRTR 2012 Annual Data Report: Intestine
J. M. Smith1,2, M. A. Skeans1, S. P. Horslen3, E. B. Edwards4,5, A. M. Harper4,5, J. J. Snyderf1,6, A. K. Israni1,6,7, B. L. Kasiske1,7
Article first published online: 28 DEC 2013
DOI: 10.1111/ajt.12582
American Journal of Transplantation
Volume 14, Issue s1, pages 97–111, January 2014

ABSTRACT
Advances in the medical and surgical treatments of intestinal failure have led to a decrease in the number of transplants over the past decade. In 2012, 152 candidates were added to the intestinal transplant waiting list, a new low. Of these, 64 were listed for intestine-liver transplant and 88 for intestinal transplant alone or with an organ other than liver. Historically, the most common organ transplanted with the intestine was the liver; this practice decreased substantially from a peak of 52.9% in 2007 to 30.0% in 2012. Short-gut syndrome, which encompasses a large group of diagnoses, is the most common etiology of intestinal failure. The pretransplant mortality rate decreased dramatically over time for all age groups, from 51.0 per 100 wait-list years in 1998–1999 to 6.7 for patients listed in 2010–2012. Numbers of intestinal and intestine-liver transplants steadily decreased from 198 in 2007 to 106 in 2012. By age, intestinal transplant recipients have changed substantially; the number of adult recipients now approximately equals the number of pediatric recipients. Graft survival has improved over the past decade. Graft failure in the first 90 days after transplant occurred in 15.7% of 2011–2012 intestinal transplant recipients, compared with 21% in 2001–2002.
Unrelated directed kidney donor in 2003, recipient and I both well.
620 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
Proud grandpa!

 

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