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Optimizing the Program-Specific Reporting of Pancreas Transplant Outcomes.
MedLine Citation:
PMID:  23289524     Owner:  NLM     Status:  Publisher    
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     Date:  2013-1-7
Journal Detail:
Title:  American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons     Volume:  -     ISSN:  1600-6143     ISO Abbreviation:  Am. J. Transplant.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100968638     Medline TA:  Am J Transplant     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
No claim to original US government works© Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.
Affiliation:
Scientific Registry of Transplant Recipients, Minneapolis Medical Research Foundation, Minneapolis, MN; Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN.
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