Faculty Collaboration Database

Renal Transplant Outcomes in Waitlist Candidates with a Previous Inactive Status Due to Being Temporarily Too Sick. Clin Transpl 2014:117-24

Date

01/01/2014

Pubmed ID

26281135

Scopus ID

2-s2.0-84940992917 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

BACKGROUND: In 2003, the United Network for Organ Sharing (UNOS) changed its policy to allow candidates with 'inactive' status to accrue time on the waitlist. In this study, we assessed the transplant outcomes among deceased donor kidney transplant (DDKT) recipients who were temporarily inactive specifically due to medical reason, i.e., being temporarily too sick (reason 7).

METHODS: Using the UNOS database, adult DDKT recipients were divided into two groups: those who had never been inactivated (active group) and those with a history of being inactive due to reason 7 (reason 7 group). Patient and graft survival, 3-year risk of death, and graft failure were examined and compared.

RESULTS: After 3 years of follow-up, patient survival in the reason 7 group was significantly lower than that of the active group (88.14% versus 91.93%, p < 0.01). The reason 7 group had a 20% increased risk of death (hazard ratio, HR 1.20, confidence interval, CI 1.04 - 1.38), a 16% increase in graft failure (HR 1.16, CI 1.06-1.28), and a 15% decrease in death-censored graft failure (HR 1.15, CI 1.01-1.31).

CONCLUSION: Recipients with a history of reason 7 have lower patient and graft survival when compared to the active group. Nonetheless, the margins of difference are minimal. Candidates with a history of reason 7 should not be discouraged from transplantation once they return to active status. Standardized criteria for placing candidates on inactive status should be developed to reduce disparities among transplant centers.

Author List

Leeaphorn N, Sampaio MS, Natal N, Mehrnia A, Kamgar M, Huang E, Kalantar-Zadeh K, Kaplan B, Bunnapradist S

Author

Mandana Kamgar MD Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Databases, Factual
Female
Graft Survival
Humans
Kaplan-Meier Estimate
Kidney Transplantation
Male
Middle Aged
Proportional Hazards Models
Risk Factors
Time Factors
Time-to-Treatment
Tissue Donors
Tissue and Organ Procurement
Treatment Outcome
United States
Waiting Lists