PREFACE

This publication was developed for the Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation, by the Organ Procurement and Transplantation Network contractor, the United Network for Organ Sharing (UNOS), and the Scientific Registry of Transplant Recipients contractor, the University Renal Research and Education Association (URREA), under contracts 231-00-0115 and 231-00-0116, respectively.  Both contracts require an Annual Data Report, though each contractor has separate responsibilities within the report. URREA coordinated the descriptive chapters and prepared the data-related sections of this report, including the Data Tables, Glossary, and Technical Notes. UNOS arranged for the report’s production and dissemination.

This Annual Report of the U.S. Organ Procurement and Transplantation Network (OPTN) and the Scientific Registry of Transplant Recipients (SRTR) represents the 15th such annual report and is based largely on data pertaining to the 10-year period from 1995 to 2004.

This preface describes the changes from previous reports and also serves as an introduction to the sections that follow.

Overviews and Highlights

More than 50 experts from many areas of the transplant community contributed to this year’s report, continuing the format established in 2002. Chapters I through X, coordinated by SRTR staff, present these experts’ descriptions of data highlights and trends. These chapters function as more than simple summaries; they are multi-authored and peer-reviewed analyses, complete with references, separate figures, and additional explanatory tables. Some of the chapters address topics traditional to the Annual Report, including trends in organ-specific and pediatric transplantation, organ donation, and database issues. Additionally, several of the chapters discuss current organ allocation policy or innovative areas of research within the transplant field.

Two of the chapters address topics that have not been examined in detail in previous annual reports: the new lung allocation system (Chapter IX) and SRTR center-specific reporting (Chapter VIII). The immunosuppression chapter (III) now examines many of the drug regimens used by pre- and posttransplant patients. We are pleased to note that slightly modified versions of these chapters are also being published as stand-alone, peer-reviewed articles in “The 2005 SRTR Report on the State of Transplantation,” a special issue of The American Journal of Transplantation .

Data Tables

Fifteen topic-specific sections of descriptive data include the summary tables referenced in the preceding chapters, as well as detailed data from the last 10 years on the following topics:

• donor, recipient, and waiting list candidate characteristics
• organ procurement and disposition
• waiting list activity, such as time to transplant and transplant and mortality rates
• posttransplant outcomes, such as graft survival, patient survival, and development of malignancies
• summarized OPO and transplant center activity
•  immunosuppression use

An important change has been made to this year’s waiting list data tables: They now focus on describing the patients who are active on the waiting list, and they also provide comparisons between active and inactive patients. This and other notable changes to the data tables are described as follows.

• Waiting list characteristics (Tables x.1, for each organ-specific section x 5-13). These tables, describing characteristics of patients awaiting transplant, now exclude patients with inactive waiting list status. New tables (Tables x.1b) have been added that compare active and inactive waiting list patients on a shorter list of characteristics (age, ethnicity/race, gender, waiting time, and primary diagnosis).
• Race and ethnicity are reported together as a single data element, reflecting their data collection (either race or ethnicity is required, but not both). Conversions from old race and ethnicity codes are described in the section “Technical Notes and Analytic Methods.”
• New immunosuppression tables describe the various drug regimens used at different time points following transplantation, as well as persistence of regimen use over time. New tables also describe the trends of steroid use in the most recent years, and its relationship with the use of different induction drugs and maintenance regimens. These new measurements reflect the changing clinical practices following the advances of the immunosuppressive drugs. The immunosuppression use tables are Table 1.9 and Tables x.6a – x.6i for each organ-specific section. Supplemental immunosuppression tables are found in Tables 15.4 through 15.6.
• The primary source of payment for each transplant is now reported in the recipient characteristics table (Table 1.10, x.4, for each organ-specific section x 5-13).
• The HLA mismatch scores are reported by individual locus (A, B, DR) in addition to the total mismatch score for kidney and pancreas in recipient characteristics and posttransplant outcome tables.
• In the deceased donor organ utilization tables (Tables 2.12 – 2.17), the numbers of organs recovered/transplanted per donor are reported by donor type — Standard Criteria Donor, Expanded Criteria Donor, and Donor after Cardiac Death.

Appendices

The Technical Notes and Analytic Methods describe all the data presented in this report, including the calculations and methods used to create the tables. The notes follow the topical order of the tables and, along with the Glossary , have been moved into the Resources section as references.

For Additional Information

•Patient inquiries:888-894-6361 (toll free)

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•Media inquiries:301-443-7577 (HRSA/DoT)
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Suggested Citation (Full) : U.S. Department of Health and Human Services. 2005 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients: Transplant Data 1995-2004. Rockville, MD: Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation (http://www.hrsa.gov/).

Suggested Citation (Abbreviated) : HHS/HRSA/HSB/DOT. 2005 OPTN/SRTR Annual Report 1995-2004 (http://www.hrsa.gov/ ).

The data and analyses reported in the 2005 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients have been supplied by UNOS and URREA under contract with HHS. The authors alone are responsible for reporting and interpreting these data; the views expressed herein are those of the authors and not necessarily those of the U.S. Government.