Harper A M, Baker A S
United Network for Organ Sharing, Richmond, Virginia, USA.
Clin Transpl. 1995:69-84.
On November 30, 1995, the combined waiting list contained 43,370 registrants, a 15.1% increase from the 37,684 registrations as of December 31, 1994. Kidney registrations accounted for the majority (70.9%) of registrations. The predominant characteristics of the registrants on the combined waiting list as of November 30, 1995 are as follows: 57.6% were male; 59.2% were White; 57% were between 18-49 years of age; 51.4% were of blood type 0; and 82% had no previous transplant. The majority of kidney registrants (68.1%) had a current PRA value of 0-19%. The number of new registrations increased 69.6% from 17,441 additions in 1988 to 29,402 in 1994. The waiting lists with the highest percentage increase in additions over this period were the lung waiting list, ranging from 125 additions in 1988 to 1,544 additions in 1994, and the liver waiting list, ranging from 2,140 additions in 1988 to 6,211 additions in 1994. Since 1992, additions to the kidney-pancreas waiting list ranged from 743 to 1,222, a 64.5% increase. Over the 1988-1992 time period, the rate of transplantation as a percentage of total waiting list registrations declined, decreasing approximately 1% per year. Meanwhile, the death rate per patient registered remained fairly stable, averaging 5.6% each year. The death rate for patients on the heart-lung waiting list decreased each year since 1989. Median waiting times increased annually for patients awaiting kidney and liver transplantation. For those registrants on the heart waiting list, median waiting times increased from 1988-1992, but decreased over the last 2 years. In contrast, lung registrants experienced decreasing median waiting times from 1988-1990, but median waiting times for lung registrants have increased since 1991. Patients awaiting heart-lung transplantation experienced the longest median waiting time in each year except 1993, when the median waiting time for kidney waiting list registrants surpassed that of heart-lung registrants. Patients awaiting liver transplantation experienced the shortest median waiting times each year except 1992. Of those patients added to the combined waiting list in 1993, patients with blood type O on the kidney, liver, heart, lung and heart-lung waiting lists had longer median waiting times than those with blood types A, B or AB. In general, patients having a previous transplant waited longer than those who had not had a previous transplant, with the exception of patients awaiting liver and pancreas transplantation. Females on the kidney, kidney-pancreas, liver, lung and heart-lung waiting lists experienced longer median waiting times than males. Median waiting times were shorter for females on the pancreas (278 vs 436 days) and heart (144 vs 240 days) waiting lists. Median waiting times were shortest for Whites registered on the kidney and lung waiting lists, for Hispanics on the liver list and for Asians on the heart and heart-lung waiting lists. Patients of ¿other¿ racial backgrounds experienced the shortest median waiting time on the kidney-pancreas waiting list. In general, pediatric patients experienced the shortest median waiting times of patients added to the waiting lists in 1993: Kidney and heart registrants less than one year of age had a median waiting time of 90 days and 47 days, respectively. Kidney-pancreas, lung and heart-lung registrants aged 1-5 years had a median waiting time of 81.5 days, 220 days, and 153 days, respectively. Conversely, older patients typically waited the longest for an organ transplant. Patients over 50 years of age experienced the longest median waiting times of patients registered on the kidney, kidney-pancreas, pancreas and heart waiting lists.
1995年11月30日,综合等候名单上有43370名登记者,比1994年12月31日的37684名登记者增加了15.1%。肾脏登记者占登记者的大多数(70.9%)。截至1995年11月30日,综合等候名单上登记者的主要特征如下:57.6%为男性;59.2%为白人;57%年龄在18至49岁之间;51.4%为O型血;82%未曾接受过移植。大多数肾脏登记者(68.1%)目前的群体反应性抗体(PRA)值为0 - 19%。新登记者数量从1988年的17441人增加到1994年的29402人,增长了69.6%。在此期间新增人数增幅最高的等候名单是肺等候名单,从1988年的125人增加到1994年的1544人,以及肝脏等候名单,从1988年的2140人增加到1994年的6211人。自1992年以来,肾脏 - 胰腺等候名单上的新增人数在743至1222人之间,增长了64.5%。在1988 - 1992年期间,移植率占总等候名单登记者的百分比下降,每年大约下降1%。与此同时,每位登记者的死亡率保持相当稳定,平均每年为5.6%。自1989年以来,心肺等候名单上患者的死亡率逐年下降。等待肾脏和肝脏移植患者的中位等待时间逐年增加。对于心脏等候名单上的那些登记者,中位等待时间在1988 - 1992年增加,但在过去两年有所下降。相比之下,肺登记者的中位等待时间在1988 - 1990年下降,但自1991年以来肺登记者的中位等待时间增加。等待心肺移植的患者除1993年外,每年的中位等待时间最长,1993年肾脏等候名单登记者的中位等待时间超过了心肺登记者。等待肝脏移植的患者除1992年外,每年的中位等待时间最短。在1993年加入综合等候名单的患者中,肾脏、肝脏、心脏、肺和心肺等候名单上O型血的患者比A型、B型或AB型血的患者中位等待时间更长。一般来说,有过移植史的患者比没有移植史的患者等待时间更长,但等待肝脏和胰腺移植的患者除外。肾脏、肾脏 - 胰腺、肝脏、肺和心肺等候名单上的女性中位等待时间比男性长。胰腺(278天对436天)和心脏(144天对240天)等候名单上女性的中位等待时间较短。肾脏和肺等候名单上登记的白人中位等待时间最短,肝脏名单上西班牙裔最短,心脏和心肺等候名单上亚洲人最短。“其他”种族背景的患者在肾脏 - 胰腺等候名单上的中位等待时间最短。一般来说,儿科患者在1993年加入等候名单的患者中中位等待时间最短:年龄小于1岁的肾脏和心脏登记者中位等待时间分别为90天和47天。年龄在1 - 5岁的肾脏 - 胰腺、肺和心肺登记者中位等待时间分别为81.5天、220天和153天。相反,老年患者通常等待器官移植的时间最长。50岁以上的患者在肾脏、肾脏 - 胰腺、胰腺和心脏等候名单上登记患者的中位等待时间最长。