TY - JOUR
T1 - Retransplant outcomes compared with first kidney transplants
T2 - Important observations not reported in the scientific registry of transplant recipients annual report
AU - Serrano, Oscar K.
AU - Matas, Arthur J.
N1 - Publisher Copyright:
© Başkent University 2020.
PY - 2020
Y1 - 2020
N2 - Objectives: Twice per year, the Scientific Registry of Transplant Recipients provides risk-adjusted center-specific reports of 1-and 3-year outcomes. In addition, the Registry reports 10-year aggregate survival outcomes for kidney transplant recipients. However, in this annual report, no distinction is made between outcomes of patients with a first transplant versus those with retransplants. Materials and Methods: We analyzed data from the Scientific Registry of Transplant Recipients between 1992 and 2015 to determine outcomes after a 1st, 2nd, or ≥ 3rd kidney transplant. Recipients were stratified by donor source (living vs deceased) and transplant number, and rates of graft failure, death-censored graft failure, and death with functioning graft were determined. Results: From 1992 to 2015, rates of graft failure and death-censored graft failure at 6 months, 1 year, 3 years, 5 years, and 10 years decreased; however, long-term rates of death with functioning graft were unchanged. Outcomes for 1st and 2nd kidney transplant were better than outcomes for ≥ 3rd transplant. Conclusions: It would be extremely valuable if the Scientific Registry of Transplant Recipients could present stratified analyses that would account for a host of factors, including organ sequence, which tend to vary by center. The presentation of risk-adjusted outcomes in the annual Registry report could include a more comprehensive assessment of program performance. Such information would be extremely useful for transplant centers, patients, and their support networks, organ procurement organizations, and other transplant stakeholders.
AB - Objectives: Twice per year, the Scientific Registry of Transplant Recipients provides risk-adjusted center-specific reports of 1-and 3-year outcomes. In addition, the Registry reports 10-year aggregate survival outcomes for kidney transplant recipients. However, in this annual report, no distinction is made between outcomes of patients with a first transplant versus those with retransplants. Materials and Methods: We analyzed data from the Scientific Registry of Transplant Recipients between 1992 and 2015 to determine outcomes after a 1st, 2nd, or ≥ 3rd kidney transplant. Recipients were stratified by donor source (living vs deceased) and transplant number, and rates of graft failure, death-censored graft failure, and death with functioning graft were determined. Results: From 1992 to 2015, rates of graft failure and death-censored graft failure at 6 months, 1 year, 3 years, 5 years, and 10 years decreased; however, long-term rates of death with functioning graft were unchanged. Outcomes for 1st and 2nd kidney transplant were better than outcomes for ≥ 3rd transplant. Conclusions: It would be extremely valuable if the Scientific Registry of Transplant Recipients could present stratified analyses that would account for a host of factors, including organ sequence, which tend to vary by center. The presentation of risk-adjusted outcomes in the annual Registry report could include a more comprehensive assessment of program performance. Such information would be extremely useful for transplant centers, patients, and their support networks, organ procurement organizations, and other transplant stakeholders.
KW - Graft failure
KW - Patient outcomes
KW - Renal transplantation
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U2 - 10.6002/ect.2018.0244
DO - 10.6002/ect.2018.0244
M3 - Article
C2 - 30806202
AN - SCOPUS:85079708241
SN - 1304-0855
VL - 18
SP - 48
EP - 52
JO - Experimental and Clinical Transplantation
JF - Experimental and Clinical Transplantation
IS - 1
ER -