PREFACE
This publication was developed for the Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation, by the Organ Procurement and Transplantation Network (OPTN) contractor, the United Network for Organ Sharing (UNOS), and the Scientific Registry of Transplant Recipients (SRTR) contractor, the Arbor Research Collaborative for Health (formerly URREA), under contracts 234-2005-37011C and 234-2005-37009C, respectively.
Both contracts require an Annual Data Report, though each contractor has separate responsibilities within the report. Arbor Research 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 OPTN and the SRTR represents the 16th such annual report and is based largely on data pertaining to the 10-year period from 1996 to 2005.
This preface describes the changes from previous reports and also serves as an introduction to the sections that follow.
Overviews and Highlights
More than 40 experts from many areas of the transplant community contributed to this year’s report, continuing the format established in 2002. Chapters I through IX, coordinated by SRTR staff, present these experts’ descriptions of data highlights and trends. 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 and donation. Additionally, several of the chapters discuss current organ allocation policy or innovative areas of research within the transplant field.
Chapters on kidney and pancreas (Chapter IV), liver and intestine (Chapter V), and heart and lung (Chapter VI) provide detailed trends in donation, waiting time, allocation, Post transplant outcomes, and the demographics of both candidates and recipients. Additionally, these chapters supplement the reporting of 10-year trends with updates on recent changes in allocation policy, immunosuppression, clinical practice, and other areas relevant to the transplantation of different organ types.
The three organ-specific chapters are preceded by a review of trends in organ donation and utilization (Chapter II) including recent efforts to increase the number of donors, and a chapter devoted to the particular outcomes and policy concerns of pediatric transplantation (Chapter III).
This year’s report concludes with three “special-focus” chapters that look closely at issues of recent interest to the transplant community. A chapter on organ acceptance rates (Chapter VII) examines what happens when transplant centers turn down kidneys offered by an organ procurement organization, as low acceptance rates may contribute to inefficiency in organ distribution. A chapter on geographic variability in access to kidney transplantation (Chapter VIII) examines rates in wait-listing, receiving a living donor kidney transplant, and receiving a deceased donor kidney transplant after being placed on the waiting list, identifying wide disparities in access across the United States. Lastly, a chapter on repeat transplantation (Chapter IX) focuses on same-organ retransplantation and its effects on the transplant community as a whole and on individual recipients, who are more likely to have inferior outcomes following retransplantation. These chapters all include special analyses performed by the SRTR and touch on topics that are timely and have implications for policy and clinical practice. We are pleased to note that slightly modified versions of all nine chapters in this report are also being published as stand-alone, peer-reviewed articles in “The 2006 SRTR Report on the State of Transplantation,” a special issue of The American Journal of Transplantation.
New to this year’s report are summary views of each of the organ-specific chapters. These short summaries include a brief overview of recent trends and several “dashboard” figures showing 10-year patterns in several key measures of transplantation: numbers of transplants, size of active waiting list, age of candidates and recipients, and graft and patient survival.
Data Tables
Fifteen topic-specific sections of descriptive data include the summary tables referenced in the preceding chapters, as well as detailed data from the last 10 years on the following topics:
· donor, recipient, and waiting list candidate characteristics
· organ procurement and disposition
· waiting list activity, such as time to transplant and transplant and mortality rates
· Post transplant outcomes, such as graft survival, patient survival, and development of malignancies
· summarized organ procurement organization and transplant center activity
· immunosuppression use
The 2006 Annual Report includes new tables showing patient and graft survival outcomes at one month, three years, five years, and 10 years, by year of transplant. Other recent methodological changes to the way the data are collected and computed are described in the Technical Notes.
Resources
The Technical Notes describe all the data presented in this report, including the calculations and methods used to create the tables. The notes follow the topical order of the data tables. The Glossary and Key to Selected Acronyms introduce readers to clinical and statistical terms that may be unfamiliar. The Resources section also includes a comprehensive List of Figures included in the report and a full set of Data Collection Worksheets.
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Suggested Citation (Full) : 2006 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients: Transplant Data 1996-2005. Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation, Rockville, MD.
Suggested Citation (Abbreviated):2006 OPTN/SRTR Annual Report 1996-2005. HHS/HRSA/HSB/DOT.
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 2006 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients have been supplied by UNOS and Arbor Research under contract with HHS. The authors alone are responsible for reporting and interpreting these data; the views expressed herein are those of the authors and not necessarily those of the U.S. Government.