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Annual Death Rate

Specifically identified in this publication as the annual death rate per 1,000 patient years at risk, it is the number of deaths for every 1,000 patient years on the waiting list. The rate is calculated by dividing the number of patients who died in a given year by the sum of the years (including partial years) that patients spent waiting and then multiplying by 1,000.

Death Rate

The death rate is calculated as the number of patient deaths per 1,000 patient years on the waiting list. The rate is calculated based on the amount of time patients are waiting. Therefore, the smaller the death rate, the smaller the number of deaths per 1,000 patient years waiting.

Median Time to Transplant

This statistic reports the time at which half of the candidates (median = 50%) will have received a transplant, among all those initially listed. If more than half of candidates are removed or die before receiving a transplant, or if the time is longer than the longest time available for the candidates included in the calculation, then this statistic is not reported. This median time to transplant considers all candidates who are initially registered on the waiting list and is generally longer than the median waiting time. It is useful for candidates at the time they are first put on the waiting list.

Median Waiting Time

This statistic reports the time at which half of the candidates registered on the waiting list would receive a transplant, if they remained active on the waiting list. It is calculated using the successive rates of transplantation seen at each time after registration, among candidates who remain active on the waiting list (dropping candidates when they die or are removed from the waiting list and excluding inactive times). This time is generally shorter than the median time to transplant since it uses transplant rates among those who remain active on the waiting list.

Medical Urgency Status Codes

Each candidate on the liver and heart waiting lists is assigned a status code which corresponds to how medically urgent it is that he or she receives a transplant. Medical urgency status for liver and heart is reported in the waiting list, recipient, and survival tables. Listed below are the definitions for each code, covering the last 10 years.

Model for End-Stage Liver Disease (MELD)

Uses three laboratory values (bilirubin, creatinine and INR) to calculate a score, on a scale of 6 to 40, that is predictive of the risk of death within three months on the liver waiting list.

Pediatric End Stage Liver Disease (PELD) Scoring System

Uses three laboratory values (albumin, bilirubin and INR), a presence of growth failure (<2 standard deviations below average height or weight), and an indicator of whether the patient is less than one year of age to calculate a score predictive of the risk of death within three months on the liver waiting list for candidates under the age of 18. The range of PELD scores is greater than that of MELD, ranging from less than zero to greater than 40. 

Percentile

The Nth percentile measure is the value at which N% of the cases are at or below that percentile. For instance, for liver waiting list registrations in 1998, the 25th percentile for waiting time is 140 days. This means that by 140 days after being added to the liver-transplant waiting list, 25% of registrants will have been transplanted. For the same group, the median is 390 days. The median is defined as the 50th percentile. For this group of liver registrants, 50% had been transplanted by 390 days.

Time to Transplant (TT)

The time between when a patient is registered on a waiting list and when that patient receives a transplant. Annual Report tables show the median and other percentiles of time to transplant. The median time to transplant is the time by which 50% of a group of registrants have received a transplant. Among the factors affecting time to transplant are the shortage of organs; biologic issues such as blood type, body size of donors and recipients, PRA, immunological factors, and medical urgency status (for liver and heart); donation rates within an area; donation request and consent procedures at OPOs; and patient registration and organ acceptance practices at transplant centers. Table 1.6 presents an alternative measure, waiting time before transplant, in which inactive time on the waiting list is not counted and patients are censored at any removal from the waiting list.

Tissue Type

An individual's combination of HLA antigens. Matching for tissue type is important in kidney and pancreas transplantation. The tissue type for each patient on the waiting list is entered into a central computer maintained by the OPTN.

United Network for Organ Sharing (UNOS)

Located in Richmond, Virginia, UNOS is a private, nonprofit membership organization that coordinates the nation's transplant system under the OPTN federal contract. UNOS assists the transplant community and the patients it serves by maintaining the national organ transplant waiting list, coordinating the matching and distribution of donated organs, increasing public awareness of the need for donated organs, serving as a forum to create and define organ sharing policies that maximize the use of donated organs, producing professional education tools, and providing extensive information about organ transplantation to patients and the public.

Waiting List

After evaluation by a team of transplant professionals, a patient is added to the national waiting list by the transplant center. Lists are specific to both geographic area and organ type: kidney, pancreas, kidney-pancreas, liver, intestine, heart, lung, and heart-lung. Each time a donor organ becomes available, a computer generates a list of potential recipients based on factors that may include genetic similarity, organ size, medical urgency, and time on the waiting list. Through this process, a new list that best matches a waiting patient to a donated organ is generated each time an organ becomes available.

Waiting List (Active)

A patient who does not have any contraindications to transplantation at the current time and is actively awaiting transplantation.

Waiting List (Inactive)

Patients can be placed on inactive status if they temporarily are not appropriate candidates for transplantation (e.g. an active infection).

Waiting List (Removal)

A patient can be removed from the waiting list voluntarily, or if he or she becomes too ill to withstand or benefit from transplantation, achieves a spontaneous recovery of organ function, receives a transplant, or dies.

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ABO Blood Type
Actual Donor
Additional Donor
Advisory Committee on Organ Transplantation (ACOT)
Allocation Policies
Allograft
Annual Death Rate
Antibody
Antigen
Cadaveric Donor
Cadaveric Transplant
Cardiomyopathy
Censoring
Centers for Medicare and Medicaid Services (CMS)
Chimerism
Cockcroft-Gault Formula
Cohort
Cold Ischemia Time (CIT)
Compliance
Confidence Interval
Congenital Heart Disease
Coronary Artery Disease
Creatinine
Crossmatch
Death Rate
Deceased Donor
Division of Transplantation (DoT)
Donation Rate
Donation Service Area
Donor
Donor Cardiac Death (DCD)
DSA
DSA
Eligible Donor
Emphysema
End-Stage Organ Failure
End-Stage Renal Disease (ESRD)
Ethnicity
Expanded Criteria Donor (ECD)
Expanded Criteria Donor (ECD) Kidneys
FEV1
Final Rule
Glomerular Filtration Rate (GFR)
Graft
Graft Survival
Haplotype
HCFA
Health Resources and Services Administration (HRSA)
Heterotopic Transplant
Histocompatibility Antigens
Human Leukocyte Antigen System (HLA System)
Immunogenicity
Immunosuppression
Induction Therapy
Informed Consent
Inotropes
Justice
Living Donor
Median Time to Transplant
Median Waiting Time
Medical Urgency Status Codes
Medical Urgency Status Codes for Heart Allocation (1999-2002)
Medical Urgency Status Codes for Heart Allocation (Pre-1999)
Medical Urgency Status Codes for Liver Allocation (1997)
Medical Urgency Status Codes for Liver Allocation (1997-2000)
Medical Urgency Status Codes for Liver Allocation (Pre-1997)
Mismatch
Model for End-Stage Liver Disease (MELD)
National Organ Transplant Act (NOTA)
Nonheartbeating Donor
OPO
Organ Preservation
Organ Procurement
Organ Procurement and Transplantation Network (OPTN)
Organ Procurement Organization (OPO)
Panel Reactive Antibody (PRA)
Patient Survival
Pediatric End Stage Liver Disease (PELD) Scoring System
Percentile
Procurement
Race
Recipient
Rejection
Scientific Registry of Transplant Recipients (SRTR)
Sensitization
Standard Error
Thoracic Organs
Time to Transplant (TT)
Tissue Type
Transplant Center
Transplant Program
Tumor
United Network for Organ Sharing (UNOS)
University Renal Research and Education Association (URREA)
Utility
Vascular
Ventricular Assist Device (VAD)
Waiting List
Waiting List (Active)
Waiting List (Inactive)
Waiting List (Removal)
Waiting Time