u s r d s tx 06
TRANSCRIPT
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Number of transplants, by donor typeFigure 7.1
transplant counts as known to the USRDS (reconciled from various sources).
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Counts of transplants from living donors, by donor relationFigure 7.2
transplant counts as known to the USRDS (reconciled from various sources).
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Incident ESRD & transplant ratesFigure 7.3
transplant rates among all ESRD patients in the given year.
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Wait list patient counts, by age, gender, & raceFigure 7.4
patients listed for kidney or kidney-pancreas transplant on December 31 of each year. Multiple listings not counted. Age determined as of December 31 of the given year.
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Wait list counts & listingsFigure 7.5
patients listed for kidney or kidney-pancreas transplant on December 31 of each year.
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Median wait times, by age, race, blood type, & PRAFigure 7.6
patients receiving deceased donor, kidney-only, first transplants; unadjusted. Year is the year of transplant, not the year the patient was first listed
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Median wait time (in years), by state, 2004Figure 7.7
patients receiving deceased donor, kidney-only, first transplants, 2004, unadjusted. State is the state of residence of the transplant recipient.
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Patients wait-listed or transplanted within one year of ESRD initiation, by age, gender, & raceFigure 7.8
patients certified as having ESRD in the given year; includes transplants of all donor types. Percents estimated using Kaplan-Meier methodology.
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Patients wait-listed or transplanted within one year of ESRD initiation, by state, 2003Figure 7.9
patients certified as having ESRD in 2003. Percents estimated using a Cox model, & adjusted for age, gender, race, & primary diagnosis. Includes transplants of all donor types
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Outcomes for first-time wait-listed patients five years after listing, 1999Figure 7.10
patients first listed for a kidney-only transplant in 1999. Patients transplanted may have subsequent outcomes within the five-year followup period.
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Transplant rates (per 100 dialysis patient years), by state, 2004Figure 7.11
per 100 dialysis patient years, 2004, adjusted for age, gender, race, & primary diagnosis.
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Transplant rates, by age, gender, race, & primary diagnosisFigure 7.12
adjusted for age, gender, race, & primary diagnosis.
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Transplant rates, by donor typeFigure 7.13
unadjusted; transplants from donors of unknown type are omitted.
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Transplant rates, by donor typeFigure 7.14
donors with a known age younger than 70, whose organs are eventually transplanted.
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Transplant rates, by donor typeFigure 7.14 (continued)
donors with a known age younger than 70, whose organs are eventually transplanted.
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Geographic variations in donation rates (per million population), by state, 2004: living donorFigure 7.15
donation rates per million population, 2004, unadjusted. Excludes patients residing in Puerto Rico & the Territories.
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Geographic variations in donation rates (per million population), by state, 2004: deceased donorFigure 7.15 (continued)
donation rates per million population, 2004, unadjusted. Excludes patients residing in Puerto Rico & the Territories.
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Deceased donations per 100 deaths, by state, 2003–2004Figure 7.16
donations per 100 deaths, July 1, 2003, to July 1, 2004; unadjusted. Excludes patients residing in Puerto Rico & the Territories.
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Graft outcomes: deceased donor transplantsFigure 7.17
first-time, kidney-only transplants. Cumulative incidences are estimated using the Kaplan-Meier method.
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Survival: deceased donor transplantsFigure 7.17 (continued)
first-time, kidney-only transplants.
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Half-lives: deceased donor transplantsFigure 7.17 (continued)
first-time, kidney-only transplants. Half-life estimates are adjusted for age, gender, race, & primary diagnosis, using Cox proporational hazards models. Conditional half-life estimates are conditional on first-year graft survival; unconditional half-life estimates are applicable at time of transplant.
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Graft outcomes: living donor transplantsFigure 7.18
first-time, kidney-only transplants. Cumulative incidences are estimated using the Kaplan-Meier method.
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Survival: living donor transplantsFigure 7.18 (continued)
first-time, kidney-only transplants.
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Half-lives: living donor transplantsFigure 7.18 (continued)
first-time, kidney-only transplants. Half-life estimates are adjusted for age, gender, race, & primary diagnosis, using Cox proporational hazards models. Conditional half-life estimates are conditional on first-year graft survival; unconditional half-life estimates are applicable at time of transplant.
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Counts of graft failures: overallFigure 7.19
preemptive retransplantations are counted here as a return to dialysis. For total patients starting or restarting dialysis, refer to Figure p.2 in the Précis.
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Counts of graft failures, by donor type & by subsequent treatmentFigure 7.19 (continued)
preemptive retransplantations are counted here as a return to dialysis.
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Patients retransplanted within one year of failureFigure 7.20
includes preemptive retransplants, & excludes failures due to death.
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Graft survival preceding return to dialysis or preemptive retransplantFigure 7.21
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Graft survival preceding return to dialysis or preemptive retransplant: grafts surviving 7+ daysFigure 7.22
patients whose grafts fail within seven days of transplant are removed from this measure in an effort to eliminate primary failures.
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Outcomes after transplantFigure 7.23
adjusted for age, gender, & race. Preemptive retransplantations are counted as a return to dialysis.
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Rates of return to dialysis or preemptive retransplant, by age, gender, & raceFigure 7.24
adjusted for age, gender, & race. Preemptive retransplantations are counted as a return to dialysis.
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Baseline calcineurin inhibitor useFigure 7.25
first-time, kidney-only transplants. Immunosuppression as identified to OPTN.
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Center-specific calcineurin inhibitor use, 2003–2004Figure 7.26
first-time, kidney-only transplants, 2003–2004. Immunosuppression as identified to OPTN. Centers are classified as using exclusively cyclosporine A/cyclosporine microemulsion, exclusively tacrolimus, both, or neither.
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Baseline antimetabolite useFigure 7.27
first-time, kidney-only transplants. Immunosuppression as identified to OPTN.
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Rapamycin useFigure 7.28
first-time, kidney-only transplants. Immunosuppression as identified to OPTN.
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Steroid useFigure 7.29
first-time, kidney-only transplants. Immunosuppression as identified to OPTN.
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Antibody inductionFigure 7.30
first-time, kidney-only transplants. Immunosuppression as identified to OPTN.
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Most common immunosuppression regimens at time of transplant: 2002–2004Figure 7.31
first-time, kidney-only transplants, 2002–2004. Maintenance immunosuppression as identified to OPTN.
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Transplants with delayed graft functionFigure 7.32
patients with functioning grafts upon discharge. Odds ratios determined using logistic regression; adjusted for age, gender, race, ethnicity, transplant year, primary diagnosis, & several clinical & donor characteristics.
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Factors associated with delayed graft function: by donor status, 2000–2004Figure 7.33
patients with functioning grafts upon discharge. Odds ratios determined using logistic regression; adjusted for age, gender, race, ethnicity, transplant year, primary diagnosis, & several clinical & donor characteristics.
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Acute rejections as reported to the OPTNFigure 7.34
ar cumulative incidence of acute rejection for transplants in the given year, as identified from OPTN followup data. Does not include acute rejection episodes at the time of tranpslant or acute rejections listed as the cause of graft failure. Kaplan-Meier methodology.
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Complications* identified through Medicare claimsFigure 7.35
first-time, kidney-only transplants, 1999–2003, with Medicare as primary payor. *three-year cumulative incidence of complications (ICD-9-CM code 996.81: complications of transplanted organ/kidney) as identified from Medicare claims. Kaplan-Meier methodology.
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Risk factors for post- transplant complications*Figure 7.36
first-time, kidney-only transplants, 1999–2003, with Medicare as primary payor. relative risk determined using Cox regression; adjusted for age, gender, race, ethnicity, transplant year, primary diagnosis, & several clinical & donor characteristics. *Complications (ICD-9-CM code 996.81: complications of transplanted organ/kidney) as identified from Medicare claims.
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Time to first post-transplant biopsyFigure 7.37
first-time, kidney-only transplants, 1999–2003, with Medicare as primary payor. three-year cumulative incidence of biopsy as identified from Medicare claims. Kaplan-Meier methodology.
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Clinical correlates to post-transplant biopsyFigure 7.38
first-time, kidney-only transplants, 1999–2003, with Medicare as primary payor. relative risk determined using Cox regression; adjusted for age, gender, race, ethnicity, transplant year, primary diagnosis, & several clinical & donor characteristics.
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Listings willing to accept an extended criteria donor (ECD) kidneyFigure 7.39
new listings: patients first wait-listed for a kidney-only transplant between January 1 & December 31 of the given year. Prevalent listings: patients on the wait list for a kidney-only transplant any time during the given year, regardless of date first listed. Multiple listings are not counted.
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Listings willing to accept an ECD kidney, by age, gender, & race, 2003–2004Figure 7.40
new listings: patients first wait-listed for a kidney-only transplant between January 1, 2003, & December 31, 2004. Prevalent listings: patients on the wait list for a kidney-only transplant any time between January 1, 2003, & December 31, 2004, regardless of date first listed. Multiple listings are not counted.
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Deceased donor transplants from an ECDFigure 7.41
first-time, deceased-donor, kidney-only transplants, 1995–2004. Expanded Criteria Donors (ECDs) are age 60 or older, or age 50–59 with two or more of the following: death attributed to CVA, history of hypertension, or creatinine > 1.5 mg/dl.
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New listings willing to accept an ECD kidney (percent), by state, 2003–2004Figure 7.42
multiple listings within a state or region are not counted, but a patient may be listed in more than one state or region.
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Prevalent listings willing to accept an ECD kidney (percent), by state, 2003–2004Figure 7.42 (continued)
multiple listings within a state or region are not counted, but a patient may be listed in more than one state or region.
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Listings willing to accept an ECD kidney, by OPTN region, 2003–2004Figure 7.43
multiple listings within a state or region are not counted, but a patient may be listed in more than one state or region.
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Patients Patients not Odds of listed for listed for listing for Adjustedan ECD an ECD an ECD odds
kidney (N) kidney (N) kidney ratioAge 0-17 149 1419 0.11 0.13
18-34 2,173 4,926 0.44 0.6835-49 (ref) 5,598 9,087 0.62 1.0050-64 9,486 9,758 0.97 1.8065+ 3,821 2,177 1.76 3.89
Gender Male (ref) 12,815 15,994 0.80 1.00Female 8,412 11,373 0.74 0.91
Race White (ref) 12,113 16,027 0.76 1.00Other 9,114 11,340 0.80 1.12
Ethnicity Hispanic 956 1,302 0.73 1.00Not Hispanic (ref) 20,181 25,833 0.78 1.06
Region 1 348 1,459 0.24 0.202 (ref) 3,610 3,379 1.07 1.003 2,912 3,234 0.90 0.864 3,086 847 3.64 3.965 1,589 9,110 0.17 0.156 497 889 0.56 0.467 2,157 2,434 0.89 0.848 1,137 1,040 1.09 1.069 2,558 500 5.12 5.4910 1,223 2,503 0.49 0.4211 2,098 1,848 1.14 1.11
Primary diagnosis Diabetes 6,897 6,570 1.05 1.29Other (ref) 12,945 18,243 0.71 1.00
Characteristics of patients willing & not willing to accept an ECD kidney, 2003–2004Table 7.a
incident wait-listed patients. Odds ratios adjusted for age, gender, ethnicity, region, primary diagnosis, PRA, & blood type. P ≤0.0001 compared to the reference group, except for non-Hispanic (p=0.37), region 8 (p=0.26), & region 11 (p=0.018).
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Observed & projected median waiting times, overall & by raceFigure 7.44
first-time, kidney-only transplants. Observed data plotted when Kaplan-Meier median is observed; otherwise, median projected using linear regression, & 95 percent confidence bands are given. Medians suppressed when cell counts <15.
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Observed & projected median waiting times, by blood type & PRAFigure 7.44 (continued)
first-time, kidney-only transplants. Observed data plotted when Kaplan-Meier median is observed; otherwise, median projected using linear regression, & 95 percent confidence bands are given. Medians suppressed when cell counts <15.
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Projected median waiting times, by OPTN regionFigure 7.45
first-time, kidney-only transplants. Observed data plotted when Kaplan-Meier median is observed; otherwise, median projected using linear regression, & 95 percent confidence bands are given. Medians suppressed when cell counts <15.
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Projected median waiting times, by OPTN regionFigure 7.45 (continued)
first-time, kidney-only transplants. Observed data plotted when Kaplan-Meier median is observed; otherwise, median projected using linear regression, & 95 percent confidence bands are given. Medians suppressed when cell counts <15.
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Projected median waiting times, by OPTN regionFigure 7.45 (continued)
first-time, kidney-only transplants. Observed data plotted when Kaplan-Meier median is observed; otherwise, median projected using linear regression, & 95 percent confidence bands are given. Medians suppressed when cell counts <15.