Renal Transplant Outcomes in Waitlist Candidates with a
Previous Inactive Status Due to Being Temporarily Too Sick.
Napat
Leeaphorn, Marcelo S. Sampaio, Naowanit Nata, Alireza Mehrnia, Mandana Kamgar,
Edmund Huang, Kamyar Kalantar-Zadeh, Bruce Kaplan, and Suphamai Bunnapradist
Clinical Transplants 2014, Chapter 14
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.
Renal Transplant Outcomes in Waitlist Candidates with a Previous Inactive Status Due to Being Temporarily Too Sick
- Product Code: CT14_Ch14
- Availability: In Stock
-
$5.00