PREFACE
The Health Resources and Services Administration (HRSA), Office of Special Programs (OSP), Division of Transplantation (DoT) contracts with the United Network for Organ Sharing (UNOS) to administer the Organ Procurement and Transplantation Network (OPTN). It also contracts with the University Renal Research and Education Association (URREA), with collaboration from the University of Michigan, to administer the Scientific Registry of Transplant Recipients (SRTR). Both contracts require an Annual Data Report, though each contractor has separate responsibilities within the report. URREA coordinated the descriptive chapters and prepared the data-related sections of this report, including the Data Tables, Glossary, and Technical Notes. UNOS arranged for the report's production and dissemination.
This Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients represents the 13th such annual report and is based largely on data collected over the 10-year period from 1993 to 2002.
The format and organization of this year's report has changed substantially from previous reports. This preface describes the largest of these changes and also serves as an introduction to the sections that follow.
The Annual Report this year is published in a new electronic version, eliminating the paper copy. Continuing in the format established in 2002, more than 40 experts from the transplant community contributed to this year's report. Along with an Executive Summary, these expert descriptions of data highlights and trends, coordinated by SRTR staff, are presented in Chapters I through X. These chapters function as more than simple summaries; they are multi-authored and peer-reviewed analyses, complete with references, separate figures, and additional explanatory tables. Some of the chapters address topics traditional to the Annual Report, including trends in organ-specific and pediatric transplantation, organ donation, and database issues. One of the chapters, "MELD/PELD," addresses topics that have not been discussed in detail in previous annual reports. The "Analytical Approaches" chapter examines many of the issues involved in selecting the analytical methods used for this report, the Center- and OPO-Specific Reports, and other SRTR analyses. We are pleased to note that slightly modified versions of these chapters also will be published as stand-alone, peer-reviewed articles in "The SRTR Report on the State of Transplantation," in a special supplement to The American Journal of Transplantation.
Data Tables
This section includes the summary tables referenced in the preceding chapters as well as detailed data on donor, recipient, and waiting list characteristics; organ procurement and disposition; graft and patient survival; immunosuppression use; waiting time to transplant; deaths on the waiting list and among recipients; and transplant center activity. Below are notable changes to this year's tables.
• Two new analytic tables are included within each set of organ-specific tables:
(1) Prevalence of People Living with a Functioning
Transplant at End of Year — Tables 5.12, 6.12, 7.12, 8.12, 9.12, 10.12, 11.12,
12.12, and 13.12
(2) Adjusted Graft and Patient Survival — Tables 5.8, 5.10,
6.8, 6.10, 7.8, 7.10, 8.8, 8.10, 9.8, 9.10, 10.8, 10.10, 11.8, 11.10, 12.8,
12.10, 13.8, and 13.10
• The liver tables now incorporate MELD/PELD as a stratification in addition to Status (Tables 9.1, 9.2, 9.3, 9.4, 9.5, 9.6, 9.7, 9.8, 9.9, 9.10, and 9.11).
• Counts of donation after cardiac death (nonheartbeating donors) are now included in the deceased donor characteristics tables (Tables 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, and 2.7).
• Expanded criteria donors are now integrated in several tables describing kidney donation and transplantation. These include deceased donor characteristics (Table 2.2), transplant recipient characteristics (Table 5.4), and death rate and survival tables (Tables 5.7, 5.8, 5.9, 5.10, and 5.11).
• The waiting list characteristics tables now refer to candidates for transplant rather than waiting list registrations.
• The death rate and survival tables use the Social Security Death Master File as an additional source of death data.
Appendices
The Technical Notes describe the data presented in the tables, including the calculations and analytical methods used. The notes follow the topical order of the tables and, along with the Glossary, have been moved into the Resources section as references.
For Additional Information
•Patient inquiries:888-894-6361 (toll free)
•Research inquiries:OPTN/UNOS Requests
804-782-4876 (phone)
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SRTR Data Requests
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Suggested Citation (Full): 2003 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients: Transplant Data 1993-2002. Department of Health and Human Services, Health Resources and Services Administration, Office of Special Programs, Division of Transplantation, Rockville, MD; United Network for Organ Sharing, Richmond, VA; University Renal Research and Education Association, Ann Arbor, MI.
Suggested Citation (Abbreviated): 2003 OPTN/SRTR Annual Report 1993-2002. HHS/HRSA/OSP/DOT; UNOS; URREA.
Publications based upon data in this report or supplied upon request must include the above citation as well as the following statement:
The data and analyses reported in the 2003 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients have been supplied by UNOS and URREA under contract with HHS. The authors alone are responsible for reporting and interpreting these data.
Most of the data in this report are provided on a voluntary basis by transplant programs, histocompatibility laboratories, and organ procurement organizations throughout the United States. HRSA, UNOS, and URREA gratefully acknowledge the work of transplant professionals whose efforts have made it possible to compile and analyze transplantation data collected across the nation. We especially wish to thank transplant data coordinators for their efforts in providing the data used in this report.
This report has been compiled through the collective efforts of many individuals. We wish to acknowledge contributions by URREA and University of Michigan staff members Valarie B. Ashby, MA; Tom Bowden; Thuy Bui; Rami Bustami, PhD; John Q. Chen, MS; Charlene R. Cole; Kerry Colligan; Laura Christensen, MS; David M. Dickinson, MA; Dawn M. Dykstra; Mary K. Guidinger, MS; Philip J. Held, PhD; Tempie E. Hulbert-Shearon, MS; Chris Kim; Greg N. Levine; Alan B. Leichtman, MD; Shannon Li, MS; Jennifer L. McCready; Keith P. McCullough, MS; Joshua J. McGowan, MS; Robert M. Merion, MD; Susan Murray, ScD; Akinlolu O. Ojo, MD, PhD; Trinh B. Pifer, MPH; Friedrich K. Port, MD, MS; Sarah H. Rush, MSW; Caroline A. Shevrin, MS; Randall L. Webb; James C. Welch; and Robert A. Wolfe, PhD.
We also wish to acknowledge contributions by UNOS staff members Kelly Balagtas; Bridgette Huff; Jack Koller; Zoran Savanovic; Alan Ting, PhD; Robbie Wagner; and Donna Whelan.
In addition to the aforementioned individuals, we gratefully acknowledge the individuals listed in Chapters I through X for their invaluable contributions to the design and implementation of these chapters.
Finally, HRSA, UNOS, and URREA gratefully acknowledge donor families and transplant recipients, whose courage has made advances in organ transplantation possible.
Amy M. Pugh, MA, OPTN Project Coordinator
Charlotte J. Arrington, SRTR Co-Editor
Sarah N. Miller, MSW, SRTR Project Coordinator
Miles P. Finley, SRTR Co-Editor
Craig Lake, MS, SRTR Co-Editor