OPTN/SRTR 2018 Annual Data Report: Kidney

Abstract

Despite the ongoing severe mismatch between organ need and supply, data from 2018 revealed some promising trends. For the fourth year in a row, the number of patients waiting for a kidney transplant in the US declined and numbers of both deceased and living donor kidney transplants increased. These encouraging trends are tempered by ongoing challenges, such as a large proportion of listed patients with dialysis time longer than 5 years. The proportion of candidates aged 65 years or older continued to rise, and the proportion undergoing transplant within 5 years of listing continued to vary dramatically nationwide, from 10% to nearly 80% across donation service areas. Increasing trends in the recovery of organs from hepatitis C positive donors and donors with anoxic brain injury warrant ongoing monitoring, as does the ongoing discard of nearly 20% of recovered organs. While the number of living donor transplants increased, racial disparities persisted in the proportion of living versus deceased donors. Strikingly, the total number of kidney transplant recipients alive with a functioning graft is on track to pass 250,000 in the next 1‐2 years. The total number of pediatric kidney transplants remained steady at 756 in 2018. Deeply concerning to the pediatric community is the persistently low level of living donor kidney transplants, representing only 36.2% in 2018.

Population Frequencies Determined by Next-generation Sequencing Provide Strategies for Prospective HLA Epitope Matching for Transplantation

“…For example, a higher mismatch score may confer a summative biological effect, or simply increase the probability of a highly immunogenic eplet being present in the donor. against the benefits achieved in prolonging outcomes [33][34][35][36] .…”

Survey of Clinician Opinions on Kidney Transplantation from Hepatitis C Virus Positive Donors: Identifying and Overcoming Barriers

“…Although the kidney transplant waitlist has increased by six-fold in 20 years, deceased and living donations have not quite doubled. 1 Unfortunately, kidneys from young donors with excellent expected long-term graft survival were historically discarded because of prior donor hepatitis C virus exposure (DHCV Ab+) or donor HCV viremia as detected by nucleic acid testing (DHCV NAT+). The prevalence of HCV exposed organs, of which 25% are DHCV NAT+, has increased more than 10-fold in the last two decades as a result of opiate overdose deaths.…”

Successful Utilization of a Live Donor Kidney with Angiomyolipoma

“…There is a large discrepancy between the number of organ donors and the number of patients on the kidney transplant list [1]. As of December 10, 2019, more than 95,000 patients are on the waiting list for a kidney transplant in the United States [2].…”