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Inactivity on the kidney transplant wait‐list is associated with inferior pre‐ and post‐transplant outcomes
Author(s) -
Norman Silas Prescod,
Kommareddi Mallika,
Luan Fu Lung
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12173
Subject(s) - medicine , kidney transplant , transplantation , kidney transplantation
Background The majority of kidney transplant ( KT ) candidates spend some time on the transplant wait‐list ( WL ) prior to kidney transplantation. We examined the impact of WL inactivity on clinical outcomes. Methods All adult KT candidates first actively wait‐listed between January 1, 1996, and December 31, 2005, in the United States were grouped by frequency of inactivity on the WL . Transplantation rate, pre‐ and post‐transplant patient survival and death‐censored kidney graft survival were compared. Results Of 159 774 candidates who were placed on the WL , 48 598 (30.4%) experienced one or more periods of inactivity. Candidates with inactivity once or more on the WL had 42% and 27% less likelihood of KT , respectively ( HR 0.58, 95% CI 0.57, 0.59 and HR 0.73, 95% CI 0.71, 0.75). WL inactivity once or more was associated with a higher likelihood of death ( HR 1.94, 95% CI 1.88, 2.00 and HR 2.13, 95% CI 2.02, 2.24). Among KT recipients, inactivity more than once on the WL was associated with a higher risk of death ( HR 1.14, 95% CI 1.05, 1.23). Conclusions Periods of inactivity on the WL predict increased mortality pre‐ and post‐transplantation. A better understanding of the reasons for WL inactivity is essential to improve WL management and post‐transplant outcomes.