Richmond, Va. -- The number of organ transplants and transplant survival rates are increasing while the demand continues to grow -- these are among the trends identified over the last decade in the comprehensive 2004 Annual Report of the U.S. Scientific Registry of Transplant Recipients and the Organ Procurement and Transplantation, released by the Health Resources and Services Administration of the U.S. Department of Health and Human Services (HHS). This report was prepared jointly by the Scientific Registry of Transplant recipients (SRTR) and the Organ Procurement and Transplantation Network (OPTN).
Collaborative Efforts Having Positive Effect on Donation
As part of the HHS' Gift of Life Donation Initiative, the Health Resources and Services Administration launched an "Organ Donation Breakthrough Collaborative" in 2003 to identify and promote the best practices in organ donation for hospitals and organ procurement organizations (OPOs). The goal of the initiative is to raise the overall donor consent rate to 75 percent among participating hospitals and OPOs. An increase in deceased donors by 4.3 percent occurred from 2002 to 2003 with the donor consents increasing by five percent.
Patient and Graft Survival Improved
Graft function and patient survival are two key outcomes measured in this report with both significantly improving over time. One-year patient survival for kidney and pancreas transplants are approximately 95 to 97 percent with corresponding survival rates at 86-87 percent for liver and heart and approximately 77 and 82 percent for lung and intestine respectively. This may be due in part to new medications introduced over the last 10 years to reduce organ rejection and diminish side effects of existing therapies.
Liver Transplants Increase, Death Rates Decrease Under Revised Policy
Nearly two years of data have been accrued since the inception of the Model for End-Stage Liver Disease (MELD) in 2002, which assesses the medical urgency of liver transplant candidates. An assessment of the effects of this allocation change notes a six percent reduction in the size of the liver waiting list, with the number of patients on the waiting list at year-end growing by 381 patients from 2002 to 2003, while the number of liver transplants increased from 5,060 in 2002 to 5,534 in 2003. The report also observes a decrease in the overall waiting list death rate over the past 10 years, from 225 deaths per 1,000 patient years at risk in 1994 to 124 in 2003.
Wait List Continues to Grow/Donor Criteria Expanding
The organ transplant waiting list saw an increase of 130 percent in the past decade from 35,751 patients at the end of 1994 to 82,885 at the end of 2003. Long wait times for transplant candidates and/or the continued growth in the waiting list size underscores the continuous dilemma of the shortage of organs.
The number of people awaiting a kidney transplant in the United States exceeded 60,000 for the first time in 2004, making it by far the most commonly transplanted and most commonly needed organ. As the kidney waiting list continues to grow, so has the increased use of expanded-criteria donor kidneys (kidneys with some increased risk of long-term graft failure due to donor's age and/or medical history). Expanded donor kidneys accounted for approximately 11 percent of the deceased donor kidney transplants performed in 1994 and increased to approximately 16 percent in 2003. ECD kidneys also made up 20 percent of all recovered deceased donor kidneys.
The OPTN/SRTR Annual Report is published exclusively in electronic formats, available on CD-ROM and the Web. The report can be accessed on the OPTN and SRTR [Exit Disclaimer] Web sites. CDs may be ordered via each site or by calling 1-804-782-4841.
The 14th Annual Report was produced by the Scientific Registry of Transplant Recipients (SRTR) contractor, University Renal Research and Education Association (URREA), in collaboration with the Organ Procurement and Transplantation Network (OPTN) contractor, United Network for Organ Sharing (UNOS), under contract with the Health Resources and Services Administration (HRSA) of the Department of Health and Human Services (HHS).