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Prevalence and Outcomes of Multiple‐Listing for Cadaveric Kidney and Liver Transplantation
Author(s) -
Merion Robert M.,
Guidinger Mary K.,
Newmann John M.,
Ellison Mary D.,
Port Friedrich K.,
Wolfe Robert A.
Publication year - 2004
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1046/j.1600-6135.2003.00282.x
Subject(s) - medicine , liver transplantation , kidney , kidney transplantation , transplantation , odds ratio , listing (finance) , relative risk , confidence interval , finance , economics
Transplant candidates are permitted to register on multiple waiting lists. We examined multiple‐listing practices and outcomes, using data on 81 481 kidney and 26 260 liver candidates registered between 7/1/95 and 6/30/00. Regression models identified factors associated with multiple‐listing and its effect on relative rates of transplantation, waiting list mortality, kidney graft failure, and liver transplant mortality. Overall, 5.8% (kidney) and 3.3% (liver) of candidates multiple‐listed. Non‐white race, older age, non‐private insurance, and lower educational level were associated with significantly lower odds of multiple‐listing. While multiple‐listed, transplantation rates were significantly higher for nearly all kidney and liver candidate subgroups (relative rate [RR]= 1.42–2.29 and 1.82–7.41, respectively). Waiting list mortality rates were significantly lower while multiple‐listed for 11 kidney subgroups (RR = 0.22–0.72) but significantly higher for 7 liver subgroups (RR = 1.44–5.93), suggesting multiple‐listing by healthier kidney candidates and sicker liver candidates. Graft failure was 10% less likely among multiple‐listed kidney recipients. Multiple‐ and single‐listed liver recipients had similar post‐transplant mortality rates. Although specific factors characterize those transplant candidates likely to multiple‐list, transplant access is significantly enhanced for almost all multiple‐listed kidney and liver candidates.