OPTN/SRTR 2017 Annual Data Report: Kidney

Abstract

Many positive trends in kidney transplantation were notable in 2017. Deceased donor kidney transplant rates and counts continued to rise, the kidney transplant waiting list declined for the third year in a row after decades of growth, and both short-and long-term allograft survival continued to improve year over year. In total, more than 220,000 patients were living in the United States with a functioning allograft. With 3 years of data available since implementation of the new kidney allocation system, better prediction of longer-term results of the allocation policy changes became possible. The data also reveal several areas in need of improvement and attention. Overall, the challenge of providing adequate access to kidney transplant persisted nationally, with additional dramatic regional variation. The proportion of living donor kidney transplants in both adults and children continued to fall, and racial disparities in living donor kidney transplant grew in the past decade. Patients at start of year 99,322 98,018 95,658 Patients added during year 30,215 30,854 30,918 Patients removed during year 31,466 33,167 33,891 Patients at end of year 98,071 95,706 92,685

Structure and diversity of urinary cell-free DNA informative of host-pathogen interactions in human urinary tract infection

“…More than 15,000 patients receive lifesaving kidney transplants in the US each year 39 . Viral and bacterial infections of the urinary tract occur frequently in this patient group and often lead to serious complications, including graft loss and death.…”

“…6 The cfDNA shotgun sequencing assay described here provides a versatile alternative 7 that will be particularly useful for the monitoring of kidney transplant recipients, given the 8 potential to enable viral and bacterial pathogen detection, antimicrobial resistance 9 profiling, and graft injury monitoring from a single assay. 10 11 More than 15,000 patients receive lifesaving kidney transplants in the US each year 48 . 12 Viral and bacterial infections of the urinary tract occur frequently in this patient group 13 and often lead to serious complications, including graft loss and death.…”

Should a homeless person become a deceased organ donor?

“…The number of transplants performed has increased annually, but over 26% are removed from kidney waiting lists due to death or being too ill and over 13 000 liver transplant candidates still remained on the active waiting list at the end of 2017. 1,2 Thus, the criteria for deceased and living donors have liberalized in hopes of using every possible organ that has a chance of functioning. 3 Donors with Public Health Service (PHS) high-risk criteria may be at higher risk for acquisition of human immunodeficiency virus (HIV) or viral hepatitis despite negative serologic testing which may affect recipient outcome.…”

The impact of transplant rejection on cutaneous squamous cell carcinoma in renal transplant recipients

“…It is estimated that approximately 9-10% of all renal transplant recipients (RTRs) each year will experience an episode of acute graft rejection. 4 The standard treatment for episodes of rejection varies by institution, but largely relies upon high-dose corticosteroids at 3-5 mg/kg daily for 3-5 days. 5,6 Thus, while it might be expected that a patient with an immune system strong enough to reject a transplanted organ would have a lower incidence of cSCC, immunosuppressive medications are known to increase the risk of cSCC and could outweigh any such protective effect.…”