The association of candidate mortality rates with kidney transplant outcomes and center performance evaluations

Transplantation
Jesse D ScholdHerwig-Ulf Meier-Kriesche

Abstract

Timely access to transplantation for eligible patients with end-stage renal disease (ESRD) is critical. However, pressures exist to improve efficiencies in transplantation and to achieve high center performance ratings, including the recently submitted "Final Rule" by Center for Medicare and Medicaid Services. This policy may affect the availability of public funding for as many as 10% of kidney transplant centers in the United States. This study examined adult solitary kidney transplant candidates from 1995 to 2005 using a national database. Mortality rates were calculated for candidates at individual centers prior to transplantation. Posttransplant survival and center's standardized mortality ratios were then calculated and compared to rates of candidate mortality. Candidate mortality rates varied substantially across centers (highest quartile with almost 2-fold elevated mortality). Recipients at centers with the highest candidate mortality rates had approximately 1.9 years reduced median graft survival for deceased donor transplants and decreased patient survival even after risk adjustment (adjusted hazard ratio=1.33, 95% confidence interval 1.25-1.41). This association was greater among living transplants (adjusted hazard r...Continue Reading

References

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Citations

Sep 19, 2009·Langenbeck's Archives of Surgery·Matthias SchwarzbachUlrich Ronellenfitsch
Mar 28, 2012·Nature Reviews. Nephrology·Jesse D Schold, Dorry L Segev
Nov 7, 2012·American Journal of Nephrology·Maria MajernikovaJitse P van Dijk
Sep 23, 2014·American Journal of Surgery·Jennifer M WilliamsKrista L Lentine
Mar 14, 2013·Current Opinion in Organ Transplantation·Lisa B VanWagner, Anton I Skaro
Jan 15, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J D ScholdD A Goldfarb
Jul 1, 2015·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Heather J Ross
Feb 24, 2010·Gastroenterology·Sumeet K AsraniW Ray Kim
Jun 6, 2009·Transplant International : Official Journal of the European Society for Organ Transplantation·Carl-Gustaf ElinderAbdul Rashid Qureshi
May 8, 2010·Clinical Transplantation·Richard J HowardJesse D Schold
Feb 5, 2009·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·E D WeinhandlB L Kasiske
Jul 31, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·D A AxelrodB Kasiske
Jul 31, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A B Massie, D L Segev
Jun 12, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·B L KasiskeS C Sweet
May 29, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J D ScholdM W Kattan
Jan 3, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·K E SchnierN Turgeon
Jan 3, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J D ScholdD A Goldfarb
Sep 16, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P MadhavanM Bhaskaran
Mar 11, 2015·Health Services Research·Jesse D Schold, Lauren Hersch Nicholas
Dec 4, 2014·Journal of the American Geriatrics Society·Jesse D Schold
Nov 2, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M A McAdams-DeMarcoD L Segev
Jun 4, 2015·Transplantation·Aditi GuptaBruce Kaplan
Oct 12, 2010·Progress in Transplantation : Official Publication, North American Transplant Coordinators Organization ... [et Al.]·Jesse D ScholdGreg Levine
Aug 28, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·D A AxelrodK L Lentine
Sep 26, 2017·Clinical Transplantation·Cory R SchaffhausenAjay K Israni
Aug 14, 2018·Transplant International : Official Journal of the European Society for Organ Transplantation·Lasse SchopmeyerRobert A Pol
Aug 10, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Deirdre Sawinski, Jayme E Locke
Mar 13, 2019·Clinical Transplantation·Cory R SchaffhausenAjay K Israni
Jun 7, 2019·Pediatric Transplantation·Lucile MarsacSouhayl Dahmani
Feb 20, 2020·Current Opinion in Organ Transplantation·Jesse D Schold
Feb 27, 2020·PloS One·Milena Dos Santos MantovaniRicardo Augusto Monteiro de Barros Almeida
Jan 1, 2014·SAGE Open Medicine·R Scott Braithwaite, Arthur Caplan
Sep 17, 2020·Transplant International : Official Journal of the European Society for Organ Transplantation·James Neuberger, Chris Callaghan

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