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Posttransplant outcome assessments at listing: Long‐term outcomes are more important than short‐term outcomes
Author(s) -
Wey Andrew,
Hart Allyson,
Salkowski Nicholas,
Skeans Melissa,
Kasiske Bertram L.,
Israni Ajay K.,
Snyder Jon J.
Publication year - 2020
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 - 10.1111/ajt.15911
Subject(s) - medicine , cohort , transplantation , liver transplantation , cohort study , listing (finance) , kidney transplantation , intensive care medicine , finance , economics
Posttransplant outcome assessments are publicly reported for patient and regulatory use. However, the currently reported 1‐year posttransplant graft survival assessments are commonly criticized for not identifying clinically meaningful differences between programs, and not providing information about longer‐term posttransplant outcomes. We investigated the association of different posttransplant outcome assessments available to patients at the time of listing with subsequent posttransplant graft survival. The posttransplant assessments were from period prevalent, rather than incident, cohorts with more timely 1‐, 3‐, and 5‐year follow‐up and 6‐, 12‐, 18‐, 24‐, and 30‐month cohort windows. The association of these assessments at listing with subsequent posttransplant graft survival included candidates listed between July 12, 2011, and December 15, 2015, who subsequently underwent transplant before December 31, 2018. The assessments with 1‐year follow‐up had uniformly weaker associations than the assessments with 3‐ and 5‐year follow‐up. The assessments with 5‐year follow‐up had the strongest association in kidney and liver transplantation. For kidney, liver, and lung transplantation, assessment windows of at least 18 months typically had the strongest associations with subsequent graft survival. Posttransplant assessments with 5‐year follow‐up and 18‐30‐month cohort windows are better than the current posttransplant assessment with 1‐year follow‐up, particularly at the time of listing.