2006 ADR

Number of transplants, by donor typeFigure 7.1

transplant counts as known to the USRDS (reconciled from various sources).

2006 ADR

Counts of transplants from living donors, by donor relationFigure 7.2

transplant counts as known to the USRDS (reconciled from various sources).

2006 ADR

Incident ESRD & transplant ratesFigure 7.3

transplant rates among all ESRD patients in the given year.

2006 ADR

Wait list patient counts, by age, gender, & raceFigure 7.4

patients listed for kidney or kidney-pancreas transplant on December 31 of each year. Multiple listings not counted. Age determined as of December 31 of the given year.

2006 ADR

Wait list counts & listingsFigure 7.5

patients listed for kidney or kidney-pancreas transplant on December 31 of each year.

2006 ADR

Median wait times, by age, race, blood type, & PRAFigure 7.6

patients receiving deceased donor, kidney-only, first transplants; unadjusted. Year is the year of transplant, not the year the patient was first listed

2006 ADR

Median wait time (in years), by state, 2004Figure 7.7

patients receiving deceased donor, kidney-only, first transplants, 2004, unadjusted. State is the state of residence of the transplant recipient.

2006 ADR

Patients wait-listed or transplanted within one year of ESRD initiation, by age, gender, & raceFigure 7.8

patients certified as having ESRD in the given year; includes transplants of all donor types. Percents estimated using Kaplan-Meier methodology.

2006 ADR

Patients wait-listed or transplanted within one year of ESRD initiation, by state, 2003Figure 7.9

patients certified as having ESRD in 2003. Percents estimated using a Cox model, & adjusted for age, gender, race, & primary diagnosis. Includes transplants of all donor types

2006 ADR

Outcomes for first-time wait-listed patients five years after listing, 1999Figure 7.10

patients first listed for a kidney-only transplant in 1999. Patients transplanted may have subsequent outcomes within the five-year followup period.

2006 ADR

Transplant rates (per 100 dialysis patient years), by state, 2004Figure 7.11

per 100 dialysis patient years, 2004, adjusted for age, gender, race, & primary diagnosis.

2006 ADR

Transplant rates, by age, gender, race, & primary diagnosisFigure 7.12

adjusted for age, gender, race, & primary diagnosis.

2006 ADR

Transplant rates, by donor typeFigure 7.13

unadjusted; transplants from donors of unknown type are omitted.

2006 ADR

Transplant rates, by donor typeFigure 7.14

donors with a known age younger than 70, whose organs are eventually transplanted.

2006 ADR

Transplant rates, by donor typeFigure 7.14 (continued)

donors with a known age younger than 70, whose organs are eventually transplanted.

2006 ADR

Geographic variations in donation rates (per million population), by state, 2004: living donorFigure 7.15

donation rates per million population, 2004, unadjusted. Excludes patients residing in Puerto Rico & the Territories.

2006 ADR

Geographic variations in donation rates (per million population), by state, 2004: deceased donorFigure 7.15 (continued)

donation rates per million population, 2004, unadjusted. Excludes patients residing in Puerto Rico & the Territories.

2006 ADR

Deceased donations per 100 deaths, by state, 2003–2004Figure 7.16

donations per 100 deaths, July 1, 2003, to July 1, 2004; unadjusted. Excludes patients residing in Puerto Rico & the Territories.

2006 ADR

Graft outcomes: deceased donor transplantsFigure 7.17

first-time, kidney-only transplants. Cumulative incidences are estimated using the Kaplan-Meier method.

2006 ADR

Survival: deceased donor transplantsFigure 7.17 (continued)

first-time, kidney-only transplants.

2006 ADR

Half-lives: deceased donor transplantsFigure 7.17 (continued)

first-time, kidney-only transplants. Half-life estimates are adjusted for age, gender, race, & primary diagnosis, using Cox proporational hazards models. Conditional half-life estimates are conditional on first-year graft survival; unconditional half-life estimates are applicable at time of transplant.

2006 ADR

Graft outcomes: living donor transplantsFigure 7.18

first-time, kidney-only transplants. Cumulative incidences are estimated using the Kaplan-Meier method.

2006 ADR

Survival: living donor transplantsFigure 7.18 (continued)

first-time, kidney-only transplants.

2006 ADR

Half-lives: living donor transplantsFigure 7.18 (continued)

first-time, kidney-only transplants. Half-life estimates are adjusted for age, gender, race, & primary diagnosis, using Cox proporational hazards models. Conditional half-life estimates are conditional on first-year graft survival; unconditional half-life estimates are applicable at time of transplant.

2006 ADR

Counts of graft failures: overallFigure 7.19

preemptive retransplantations are counted here as a return to dialysis. For total patients starting or restarting dialysis, refer to Figure p.2 in the Précis.

2006 ADR

Counts of graft failures, by donor type & by subsequent treatmentFigure 7.19 (continued)

preemptive retransplantations are counted here as a return to dialysis.

2006 ADR

Patients retransplanted within one year of failureFigure 7.20

includes preemptive retransplants, & excludes failures due to death.

2006 ADR

Graft survival preceding return to dialysis or preemptive retransplantFigure 7.21

2006 ADR

Graft survival preceding return to dialysis or preemptive retransplant: grafts surviving 7+ daysFigure 7.22

patients whose grafts fail within seven days of transplant are removed from this measure in an effort to eliminate primary failures.

2006 ADR

Outcomes after transplantFigure 7.23

adjusted for age, gender, & race. Preemptive retransplantations are counted as a return to dialysis.

2006 ADR

Rates of return to dialysis or preemptive retransplant, by age, gender, & raceFigure 7.24

adjusted for age, gender, & race. Preemptive retransplantations are counted as a return to dialysis.

2006 ADR

Baseline calcineurin inhibitor useFigure 7.25

first-time, kidney-only transplants. Immunosuppression as identified to OPTN.

2006 ADR

Center-specific calcineurin inhibitor use, 2003–2004Figure 7.26

first-time, kidney-only transplants, 2003–2004. Immunosuppression as identified to OPTN. Centers are classified as using exclusively cyclosporine A/cyclosporine microemulsion, exclusively tacrolimus, both, or neither.

2006 ADR

Baseline antimetabolite useFigure 7.27

first-time, kidney-only transplants. Immunosuppression as identified to OPTN.

2006 ADR

Rapamycin useFigure 7.28

first-time, kidney-only transplants. Immunosuppression as identified to OPTN.

2006 ADR

Steroid useFigure 7.29

first-time, kidney-only transplants. Immunosuppression as identified to OPTN.

2006 ADR

Antibody inductionFigure 7.30

first-time, kidney-only transplants. Immunosuppression as identified to OPTN.

2006 ADR

Most common immunosuppression regimens at time of transplant: 2002–2004Figure 7.31

first-time, kidney-only transplants, 2002–2004. Maintenance immunosuppression as identified to OPTN.

2006 ADR

Transplants with delayed graft functionFigure 7.32

patients with functioning grafts upon discharge. Odds ratios determined using logistic regression; adjusted for age, gender, race, ethnicity, transplant year, primary diagnosis, & several clinical & donor characteristics.

2006 ADR

Factors associated with delayed graft function: by donor status, 2000–2004Figure 7.33

patients with functioning grafts upon discharge. Odds ratios determined using logistic regression; adjusted for age, gender, race, ethnicity, transplant year, primary diagnosis, & several clinical & donor characteristics.

2006 ADR

Acute rejections as reported to the OPTNFigure 7.34

ar cumulative incidence of acute rejection for transplants in the given year, as identified from OPTN followup data. Does not include acute rejection episodes at the time of tranpslant or acute rejections listed as the cause of graft failure. Kaplan-Meier methodology.

2006 ADR

Complications* identified through Medicare claimsFigure 7.35

first-time, kidney-only transplants, 1999–2003, with Medicare as primary payor. *three-year cumulative incidence of complications (ICD-9-CM code 996.81: complications of transplanted organ/kidney) as identified from Medicare claims. Kaplan-Meier methodology.

2006 ADR

Risk factors for post- transplant complications*Figure 7.36

first-time, kidney-only transplants, 1999–2003, with Medicare as primary payor. relative risk determined using Cox regression; adjusted for age, gender, race, ethnicity, transplant year, primary diagnosis, & several clinical & donor characteristics. *Complications (ICD-9-CM code 996.81: complications of transplanted organ/kidney) as identified from Medicare claims.

2006 ADR

Time to first post-transplant biopsyFigure 7.37

first-time, kidney-only transplants, 1999–2003, with Medicare as primary payor. three-year cumulative incidence of biopsy as identified from Medicare claims. Kaplan-Meier methodology.

2006 ADR

Clinical correlates to post-transplant biopsyFigure 7.38

first-time, kidney-only transplants, 1999–2003, with Medicare as primary payor. relative risk determined using Cox regression; adjusted for age, gender, race, ethnicity, transplant year, primary diagnosis, & several clinical & donor characteristics.

2006 ADR

Listings willing to accept an extended criteria donor (ECD) kidneyFigure 7.39

new listings: patients first wait-listed for a kidney-only transplant between January 1 & December 31 of the given year. Prevalent listings: patients on the wait list for a kidney-only transplant any time during the given year, regardless of date first listed. Multiple listings are not counted.

2006 ADR

Listings willing to accept an ECD kidney, by age, gender, & race, 2003–2004Figure 7.40

new listings: patients first wait-listed for a kidney-only transplant between January 1, 2003, & December 31, 2004. Prevalent listings: patients on the wait list for a kidney-only transplant any time between January 1, 2003, & December 31, 2004, regardless of date first listed. Multiple listings are not counted.

2006 ADR

Deceased donor transplants from an ECDFigure 7.41

first-time, deceased-donor, kidney-only transplants, 1995–2004. Expanded Criteria Donors (ECDs) are age 60 or older, or age 50–59 with two or more of the following: death attributed to CVA, history of hypertension, or creatinine > 1.5 mg/dl.

2006 ADR

New listings willing to accept an ECD kidney (percent), by state, 2003–2004Figure 7.42

multiple listings within a state or region are not counted, but a patient may be listed in more than one state or region.

2006 ADR

Prevalent listings willing to accept an ECD kidney (percent), by state, 2003–2004Figure 7.42 (continued)

multiple listings within a state or region are not counted, but a patient may be listed in more than one state or region.

2006 ADR

Listings willing to accept an ECD kidney, by OPTN region, 2003–2004Figure 7.43

multiple listings within a state or region are not counted, but a patient may be listed in more than one state or region.

2006 ADR

Patients Patients not Odds of listed for listed for listing for Adjustedan ECD an ECD an ECD odds

kidney (N) kidney (N) kidney ratioAge 0-17 149 1419 0.11 0.13

18-34 2,173 4,926 0.44 0.6835-49 (ref) 5,598 9,087 0.62 1.0050-64 9,486 9,758 0.97 1.8065+ 3,821 2,177 1.76 3.89

Gender Male (ref) 12,815 15,994 0.80 1.00Female 8,412 11,373 0.74 0.91

Race White (ref) 12,113 16,027 0.76 1.00Other 9,114 11,340 0.80 1.12

Ethnicity Hispanic 956 1,302 0.73 1.00Not Hispanic (ref) 20,181 25,833 0.78 1.06

Region 1 348 1,459 0.24 0.202 (ref) 3,610 3,379 1.07 1.003 2,912 3,234 0.90 0.864 3,086 847 3.64 3.965 1,589 9,110 0.17 0.156 497 889 0.56 0.467 2,157 2,434 0.89 0.848 1,137 1,040 1.09 1.069 2,558 500 5.12 5.4910 1,223 2,503 0.49 0.4211 2,098 1,848 1.14 1.11

Primary diagnosis Diabetes 6,897 6,570 1.05 1.29Other (ref) 12,945 18,243 0.71 1.00

Characteristics of patients willing & not willing to accept an ECD kidney, 2003–2004Table 7.a

incident wait-listed patients. Odds ratios adjusted for age, gender, ethnicity, region, primary diagnosis, PRA, & blood type. P ≤0.0001 compared to the reference group, except for non-Hispanic (p=0.37), region 8 (p=0.26), & region 11 (p=0.018).

2006 ADR

Observed & projected median waiting times, overall & by raceFigure 7.44

first-time, kidney-only transplants. Observed data plotted when Kaplan-Meier median is observed; otherwise, median projected using linear regression, & 95 percent confidence bands are given. Medians suppressed when cell counts <15.

2006 ADR

Observed & projected median waiting times, by blood type & PRAFigure 7.44 (continued)

first-time, kidney-only transplants. Observed data plotted when Kaplan-Meier median is observed; otherwise, median projected using linear regression, & 95 percent confidence bands are given. Medians suppressed when cell counts <15.

2006 ADR

Projected median waiting times, by OPTN regionFigure 7.45

first-time, kidney-only transplants. Observed data plotted when Kaplan-Meier median is observed; otherwise, median projected using linear regression, & 95 percent confidence bands are given. Medians suppressed when cell counts <15.

2006 ADR

Projected median waiting times, by OPTN regionFigure 7.45 (continued)

first-time, kidney-only transplants. Observed data plotted when Kaplan-Meier median is observed; otherwise, median projected using linear regression, & 95 percent confidence bands are given. Medians suppressed when cell counts <15.

2006 ADR

Projected median waiting times, by OPTN regionFigure 7.45 (continued)

first-time, kidney-only transplants. Observed data plotted when Kaplan-Meier median is observed; otherwise, median projected using linear regression, & 95 percent confidence bands are given. Medians suppressed when cell counts <15.