Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN, USA.
Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN, USA.
Am J Transplant. 2019 Feb;19(2):399-406. doi: 10.1111/ajt.15032. Epub 2018 Aug 21.
The Scientific Registry of Transplant Recipients (SRTR) is responsible for understandable reporting of program metrics, including transplant rate, waitlist mortality, and posttransplant outcomes. SRTR developed five-tier systems for each metric to improve accessibility for the public. We investigated the associations of the five-tier assignments at listing with all-cause candidate mortality after listing, for candidates listed July 12, 2011-June 16, 2014. Transplant rate evaluations with one additional tier were associated with lower mortality after listing in kidney (hazard ratio [HR], 0.95 ), liver (HR, 0.90 ), and heart (HR, 0.96 ) transplantation. For lung transplant patients, mortality after listing was highest at programs with above- and below-average transplant rates and lowest at programs with average transplant rates, suggesting that aggressive acceptance behavior may not always provide a survival benefit. Waitlist mortality evaluations with one additional tier were associated with lower mortality after listing in kidney (HR, 0.96 ) transplantation, and posttransplant graft survival evaluations with one additional tier were associated with lower mortality after listing in lung (HR, 0.94 ) transplantation. Transplant rate typically had the strongest association with mortality after listing, but the strength of associations differed by organ.
移植受者科学登记处（SRTR）负责以通俗易懂的方式报告计划指标，包括移植率、候补者死亡率和移植后结果。SRTR 为每个指标开发了五级系统，以提高公众的可访问性。我们研究了在 2011 年 7 月 12 日至 2014 年 6 月 16 日期间列出的五个级别与列出后的所有原因候选者死亡率之间的关联。与一个额外级别相关的移植率评估与列出后的死亡率降低相关，包括肾脏（风险比 [HR]，0.95）、肝脏（HR，0.90）和心脏（HR，0.96）移植。对于肺移植患者，在移植率高于和低于平均水平的项目中，列出后的死亡率最高，而在移植率平均的项目中，死亡率最低，这表明积极的接受行为可能并不总是提供生存获益。与一个额外级别相关的候补者死亡率评估与肾脏（HR，0.96）移植后死亡率降低相关，与一个额外级别相关的移植后移植物存活率评估与肺（HR，0.94）移植后死亡率降低相关。移植率通常与列出后的死亡率关联最强，但关联的强度因器官而异。
