Abstract: SA-PO097
The Impact of Systematic Review of Status 7 Patients on the Kidney Transplant Waitlist
Session Information
- Transplantation: Recipient and Donor Assessment
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1802 Transplantation: Clinical
Authors
- Kataria, Ashish, Erie County Medical Center, Buffalo, New York, United States
- Venuto, Rocco C., Erie County Medical Center, Buffalo, New York, United States
- Von Visger, Jon R., Erie County Medical Center, Buffalo, New York, United States
- Chang, Shirley Shwu-Shiow, Erie County Medical Center, Buffalo, New York, United States
- Lamphron, Bryan, Erie County Medical Center, Buffalo, New York, United States
- Shah, Vaqar H., University at Buffalo, Buffalo, New York, United States
- Gundroo, Aijaz A., Erie County Medical Center, Buffalo, New York, United States
Background
Patients (pts) listed status 7 on the kidney transplant (Tx) waitlist are more likely to die rather than be transplanted. They need to overcome one or more barriers in order to move to status 1. These barriers could either be medical or psycho-social (PS) but are significant enough to exclude them from recieving organ offers. We speculated that by systematically re-evaluating status 7 pts, we might overcome the barriers and expedite their Tx.
Methods
Biweekly status 7 re-evaluation meetings were started in April 2016 and continued through April 2018. The attendees were a transplant physician champion and members of all components of the transplant team. These were held in parallel to the recipient selection meetings. For each status 7 patient, the attendees performed an intense scrutiny of the individual barriers against activation and developed a specific action plan. A descriptive analysis of the status 7 pts at the start and end of study was performed and patient demographic and listing outcomes were studied.
Results
A total of 266 status 7 pts were evaluated(Table1). 18.4% of them overcame remaining barriers preventing activation and majority (85.7%) in this group recieved a Tx after being inactive on the waitlist for average 805 days. 39% of inactive patients were deemed ineligible and were removed from the waitlist. These pts were older than those who recieved a Tx (mean age 60.6 versus 52.7 years) and were inactive for average 1593 days. 17.6% status 7 pts died while only 73 (27.4%) pts still remain inactive on the waitlist. Common barriers against activation were CP and PS issues in all categories.
Conclusion
Re-evaluation of status 7 pts has the potential to expedite their transplantation or removal of those pts from the waitlist who are unlikely to get activated for a kidney Tx. We have incorporated this process on a continuing basis.
| Current waitlist status | Status 7 | Activated and/or transplanted | Died | Removed from the waitlist |
| Number of patients(%) | 73(27.4%) | 49(18.4%) activated; 42 of these transplanted | 47(17.6%) | 104(39%) |
| Mean age (years) | 51.3 | 53.4 | 59.3 | 60 |
| Common barriers against activation(%) | CP(52) PS(30) | CP(41) PS(33) Onc(17) | CP(54) PS(21) Onc(15) I(13) | CP(46) PS(26) Onc(10) |
| Average inactive duration (days) | 1685 | 805 | 1198 | 1593 |
CP-Cardio-pulmonary, PS-Psycho-social, Onc-Oncologic, I-Infection