Trends in Survival for Adult Organ Transplantation
Objective:. Intent-to-treat analysis follows patients from listing to death, regardless of their transplant status, and aims to provide a more holistic scope of the progress made in adult solid-organ transplantation. Background:. Many studies have shown progress in waitlist and post-transplant survi...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-03-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000383 |
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| author | Grant Patrick, BS Brian Hickner, MD Karthik Goli, BS Liam D. Ferreira, MBA John Goss, MD Abbas Rana, MD |
| author_facet | Grant Patrick, BS Brian Hickner, MD Karthik Goli, BS Liam D. Ferreira, MBA John Goss, MD Abbas Rana, MD |
| author_sort | Grant Patrick, BS |
| collection | DOAJ |
| description | Objective:. Intent-to-treat analysis follows patients from listing to death, regardless of their transplant status, and aims to provide a more holistic scope of the progress made in adult solid-organ transplantation.
Background:. Many studies have shown progress in waitlist and post-transplant survival for adult kidney, liver, heart, and lung transplants, but there is a need to provide a more comprehensive perspective of transplant outcomes for patients and their families.
Methods:. Univariable and multivariable Cox regression analyses were used to analyze factors contributing to intent-to-treat survival in 813,862 adults listed for kidney, liver, heart, and lung transplants. The Kaplan–Meier method was used to examine changes in waitlist, post-transplant, and intent-to-treat survival. Transplantation rates were compared using χ2 tests.
Results:. Intent-to-treat survival has steadily increased for liver, heart, and lung transplants. The percentage of patients transplanted within 1 year significantly increased for heart (57.4% from 52.9%) and lung (73.5% from 33.2%). However, the percentage of patients transplanted within 1 year significantly decreased from 35.8% to 21.2% for kidney transplant. Notably, intent-to-treat survival has decreased for kidneys despite increases in waitlist and post-transplant survival, likely because of the decreased transplant rate.
Conclusion:. Intent-to-treat survival steadily improved for liver, heart, and lung transplant over the 30-year study period. Continued advancements in allocation policy, immunosuppression, and improved care of patients on the waitlist may contribute to further progress in outcomes of all organs, but the increasing discrepancy in supply and demand of donor kidneys is alarming and has impeded the progress of kidney intent-to-treat survival. |
| format | Article |
| id | doaj-art-131fd67dff2e46378e19d204dd8709ff |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-131fd67dff2e46378e19d204dd8709ff2025-01-24T09:18:25ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-03-0151e38310.1097/AS9.0000000000000383202403000-00025Trends in Survival for Adult Organ TransplantationGrant Patrick, BS0Brian Hickner, MD1Karthik Goli, BS2Liam D. Ferreira, MBA3John Goss, MD4Abbas Rana, MD5From the * Department of Student Affairs, Baylor College of Medicine, Houston, Texas† Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, TexasFrom the * Department of Student Affairs, Baylor College of Medicine, Houston, TexasFrom the * Department of Student Affairs, Baylor College of Medicine, Houston, Texas‡ Division of Abdominal Transplantation, Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, Texas.‡ Division of Abdominal Transplantation, Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, Texas.Objective:. Intent-to-treat analysis follows patients from listing to death, regardless of their transplant status, and aims to provide a more holistic scope of the progress made in adult solid-organ transplantation. Background:. Many studies have shown progress in waitlist and post-transplant survival for adult kidney, liver, heart, and lung transplants, but there is a need to provide a more comprehensive perspective of transplant outcomes for patients and their families. Methods:. Univariable and multivariable Cox regression analyses were used to analyze factors contributing to intent-to-treat survival in 813,862 adults listed for kidney, liver, heart, and lung transplants. The Kaplan–Meier method was used to examine changes in waitlist, post-transplant, and intent-to-treat survival. Transplantation rates were compared using χ2 tests. Results:. Intent-to-treat survival has steadily increased for liver, heart, and lung transplants. The percentage of patients transplanted within 1 year significantly increased for heart (57.4% from 52.9%) and lung (73.5% from 33.2%). However, the percentage of patients transplanted within 1 year significantly decreased from 35.8% to 21.2% for kidney transplant. Notably, intent-to-treat survival has decreased for kidneys despite increases in waitlist and post-transplant survival, likely because of the decreased transplant rate. Conclusion:. Intent-to-treat survival steadily improved for liver, heart, and lung transplant over the 30-year study period. Continued advancements in allocation policy, immunosuppression, and improved care of patients on the waitlist may contribute to further progress in outcomes of all organs, but the increasing discrepancy in supply and demand of donor kidneys is alarming and has impeded the progress of kidney intent-to-treat survival.http://journals.lww.com/10.1097/AS9.0000000000000383 |
| spellingShingle | Grant Patrick, BS Brian Hickner, MD Karthik Goli, BS Liam D. Ferreira, MBA John Goss, MD Abbas Rana, MD Trends in Survival for Adult Organ Transplantation Annals of Surgery Open |
| title | Trends in Survival for Adult Organ Transplantation |
| title_full | Trends in Survival for Adult Organ Transplantation |
| title_fullStr | Trends in Survival for Adult Organ Transplantation |
| title_full_unstemmed | Trends in Survival for Adult Organ Transplantation |
| title_short | Trends in Survival for Adult Organ Transplantation |
| title_sort | trends in survival for adult organ transplantation |
| url | http://journals.lww.com/10.1097/AS9.0000000000000383 |
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