OPTN/SRTR 2011 Annual Data Report: Kidney

Authors

  • A. J. Matas,

    1. Scientifc Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
    2. Department of Surgery, University of Minnesota, Minneapolis, Minnesota
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  • J. M. Smith,

    1. Scientifc Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
    2. Department of Pediatrics, University of Washington, Seatle, Washington
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  • M. A. Skeans,

    1. Scientifc Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
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  • K. E. Lamb,

    1. Scientifc Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
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  • S. K. Gustafson,

    1. Scientifc Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
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  • C. J. Samana,

    1. Organ Procurement and Transplantation Network, Richmond, Virginia
    2. United Network for Organ Sharing, Richmond, Virginia
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  • D. E. Stewart,

    1. Organ Procurement and Transplantation Network, Richmond, Virginia
    2. United Network for Organ Sharing, Richmond, Virginia
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  • J. J. Snyder,

    1. Scientifc Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
    2. Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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  • A. K. Israni,

    1. Scientifc Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
    2. Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
    3. Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, Minnesota
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  • B. L. Kasiske

    1. Scientifc Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
    2. Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, Minnesota
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Abstract

ABSTRACT  A shortage of kidneys for transplant remains a major problem for patients with end-stage renal disease. The number of candidates on the waiting list continues to increase each year, while organ donation numbers remain flat. Thus, transplant rates for adult wait-listed candidates continue to decrease. However, pretransplant mortality rates also show a decreasing trend. Many kidneys recovered for transplant are discarded, and discard rates are increasing. Living donation rates have been essentially unchanged for the past decade, despite introduction of desensitization, non-directed donations, and kidney paired donation programs. For both living and deceased donor recipients, early posttransplant results have shown ongoing improvement, driven by decreases in rates of graft failure and return to dialysis. Immunosuppressive drug use has changed little, except for the Food and Drug Administration approval of belatacept in 2011, the first approval of a maintenance immunosuppressive drug in more than a decade. Pediatric kidney transplant candidates receive priority under the Share 35 policy. The number of pediatric transplants peaked in 2005, and decreased to a low of 760 in 2011. Graft survival and short-term renal function continue to improve for pediatric recipients. Posttransplant lymphoproliferative disorder is an important concern, occurring in about one-third of pediatric recipients.

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