UK Renal Registry 16th Annual Report: Chapter 4 Demography of Patients Wait-listed for Renal Transplantation in the UK: National and Centre-specific Analyses

TY - JOUR

T1 - UK Renal Registry 16th Annual Report

T2 - Chapter 4 Demography of Patients Wait-listed for Renal Transplantation in the UK: National and Centre-specific Analyses

AU - Pruthi, Rishi

AU - Hilton, Rachel

AU - Pankhurst, Laura

AU - Mamode, Nizam

AU - Hudson, Alex

AU - Roderick, Paul

AU - Ravanan, Rommel

PY - 2014/2

Y1 - 2014/2

N2 - Introduction: For suitable patients, renal transplantation is considered the optimal modality of renal replacement therapy, with availability of donor organs limiting the number of transplants undertaken. The 2006 kidney allocation policy was developed to ensure equity of allocation to patients on the transplant waiting list, whilst still achieving a good donor/recipient match. This study aims to describe the characteristics of the kidney transplant waiting list and variations in median waiting times. Methods: Demographics and clinical characteristics of all patients listed for a kidney only transplant in the UK on 1st January 2011 were examined. Renal unit variations were explored. Patients listed between January 2006 and December 2009 were included in analysis of waiting times to transplant. Results: At the beginning of 2011, there were 6,699 patients registered active for kidney only transplant in UK; a prevalence rate of 107 pmp. The median age of prevalent listed patients was 53 years, with 8% aged 70 or above. Of the patients listed, 84% had started renal replacement therapy (RRT), 59% were male, 28% were from ethnic minorities, 50% had blood group type O, 28% were defined as difficult to HLA match and 23% were highly sensitised (calculated HLA antibody reaction frequency 85%). Median waiting time to transplant was 38 months. Waiting time was shorter for White patients (36 months) compared to Asian or Black patients (46 months), and was doubled in highly sensitised compared to un-sensitised patients. Conclusions: Inter-centre variation was observed in the rate of wait-listing and in the proportion of listed patients across different ethnic groups, age, blood groups and level of sensitisation. This may reflect differences in baseline population characteristics as well as individual centre practice patterns. Median waiting times differ significantly across blood groups, degree of sensitisation and ethnic group.

AB - Introduction: For suitable patients, renal transplantation is considered the optimal modality of renal replacement therapy, with availability of donor organs limiting the number of transplants undertaken. The 2006 kidney allocation policy was developed to ensure equity of allocation to patients on the transplant waiting list, whilst still achieving a good donor/recipient match. This study aims to describe the characteristics of the kidney transplant waiting list and variations in median waiting times. Methods: Demographics and clinical characteristics of all patients listed for a kidney only transplant in the UK on 1st January 2011 were examined. Renal unit variations were explored. Patients listed between January 2006 and December 2009 were included in analysis of waiting times to transplant. Results: At the beginning of 2011, there were 6,699 patients registered active for kidney only transplant in UK; a prevalence rate of 107 pmp. The median age of prevalent listed patients was 53 years, with 8% aged 70 or above. Of the patients listed, 84% had started renal replacement therapy (RRT), 59% were male, 28% were from ethnic minorities, 50% had blood group type O, 28% were defined as difficult to HLA match and 23% were highly sensitised (calculated HLA antibody reaction frequency 85%). Median waiting time to transplant was 38 months. Waiting time was shorter for White patients (36 months) compared to Asian or Black patients (46 months), and was doubled in highly sensitised compared to un-sensitised patients. Conclusions: Inter-centre variation was observed in the rate of wait-listing and in the proportion of listed patients across different ethnic groups, age, blood groups and level of sensitisation. This may reflect differences in baseline population characteristics as well as individual centre practice patterns. Median waiting times differ significantly across blood groups, degree of sensitisation and ethnic group.

KW - Blood group

KW - Calculated reaction frequency

KW - Demography

KW - End stage renal disease

KW - Established renal failure

KW - Ethnicity

KW - Kidney allocation

KW - Match grade

KW - Prevalence

KW - Renal replacement therapy

KW - Transplantation

KW - Transplant waiting list

KW - Wait listing times

U2 - 10.1159/000360023

DO - 10.1159/000360023

M3 - Article

SN - 1660-2110

VL - 125

SP - 81

EP - 98

JO - NEPHRON CLINICAL PRACTICE

JF - NEPHRON CLINICAL PRACTICE

IS - 1-4

ER -