Document Detail


Optimizing the program-specific reporting of pancreas transplant outcomes.
MedLine Citation:
PMID:  23289524     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The Scientific Registry of Transplant Recipients is charged with providing program-specific reports for organ transplant programs in the United States. Monitoring graft survival for pancreas transplant programs has been problematic as there are three different pancreas transplant procedures that may have different outcomes, and analyzing them separately reduces events and statistical power. We combined two consecutive 2.5-year cohorts of transplant recipients to develop Cox proportional hazards models predicting outcomes, and tested these models in the second 2.5-year cohort. We used separate models for 1- and 3-year graft and patient survival for each transplant type: simultaneous pancreas-kidney (SPK), pancreas after kidney (PAK) and pancreas transplant alone (PTA). We first built a predictive model for each pancreas transplant type, and then pooled the transplant types within centers to compare total observed events with total predicted events. Models for 1-year pancreas graft and patient survival yielded C statistics of 0.65 (95% confidence interval, 0.63-0.68) and 0.66 (0.61-0.72), respectively, comparable to C statistics for 1-year patient and graft survival for other organ transplants. Model calibration (Hosmer-Lemeshow method) was also acceptable. We conclude that pooling the results of SPK, PAK and PTA can produce potentially useful models for reporting program-specific pancreas transplant outcomes.
Authors:
B L Kasiske; S Gustafson; N Salkowski; P G Stock; D A Axelrod; R Kandaswamy; E F Sleeman; J Wainright; A K Israni; J J Snyder
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-01-07
Journal Detail:
Title:  American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons     Volume:  13     ISSN:  1600-6143     ISO Abbreviation:  Am. J. Transplant.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-29     Completed Date:  2013-07-25     Revised Date:  2014-02-14    
Medline Journal Info:
Nlm Unique ID:  100968638     Medline TA:  Am J Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  337-47     Citation Subset:  IM    
Copyright Information:
No claim to original US government works© Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.
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MeSH Terms
Descriptor/Qualifier:
Adult
Algorithms
Cohort Studies
Female
Graft Survival
Humans
Immunosuppression
Kidney Transplantation / methods,  standards
Linear Models
Male
Middle Aged
Pancreas Transplantation / methods*,  mortality,  standards*
Pancreatic Diseases / therapy
Proportional Hazards Models
Registries / standards*
Renal Insufficiency / therapy
Tissue and Organ Procurement / methods*
Treatment Outcome
United States
Grant Support
ID/Acronym/Agency:
P30 DK063720/DK/NIDDK NIH HHS
Comments/Corrections
Comment In:
Am J Transplant. 2013 Feb;13(2):251-2   [PMID:  23356896 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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