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2009 SRTR Report on the State of Transplantation

2010; Elsevier BV; Volume: 10; Issue: 4 Linguagem: Inglês

10.1111/j.1600-6143.2010.03072.x

1600-6143

Robert M. Merion,

Organ and Tissue Transplantation Research

The sweep of challenges facing the transplant community was strikingly apparent this year as we prepared the eighth annual issue of the Scientific Registry of Transplant Recipients (SRTR) Report on the State of Transplantation.Review of every organ and of each special focus topic sparked a battery of analyses to explore new lines of inquiry. At the SRTR, we are impressed by the intellectual curiosity and commitment brought to this project by the more than 60 experts from around the country who examined the latest data submitted to the Organ Procurement and Transplantation Network (OPTN). In a spirit of true collaboration, these authors have written the 10 high-quality peer-reviewed articles that make up the special issue you are now reading — our annual effort to identify emerging data trends in the field of transplantation. The data underlying these papers can be found in the tables of the OPTN/SRTR Annual Report, published each year by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services. So that you can more easily reference the source information at the SRTR web site (www.ustransplant.org) the specific Annual Report table references are noted in brackets throughout each article. This year, we are pleased to offer an in-depth look at intestine transplantation, separating it for the first time into a free-standing article. Over time, there have been many improvements in intestine transplantation, including increased graft and patient survival. Our authors document these successes and review OPTN policy, while also highlighting continuing concerns, such as high waiting list mortality; the role of multiple organ transplants and waiting list practices; the potential to increase intestine utilization from existing deceased donors; and longer-term outcomes such as immunosuppression and kidney function, the use of parenteral nutrition, and the increasing role of retransplantation. This year's report also offers three special focus articles on topics highly relevant to the transplant community. The first article examines the effect of demand for kidney transplantation, measured by the incidence of end-stage renal disease (ESRD), on access to transplantation. Patients living in medium and high ESRD areas had lower rates of transplantation from the waiting list compared with those in low ESRD areas. The second article studies the effect of the incorporation of DonorNet® , the electronic deceased donor organ offer system, by looking at the match run offer number for organ placement and overall organ use, with a focus on ischemia time and graft outcomes. The third special focus article, co-written by members of the OPTN Minority Affairs Committee and investigators from the SRTR, probes a less explored, but vital area of transplantation: differences in posttransplant outcomes among patients of specific racial and ethnic groups. The SRTR team will continue to offer cutting-edge special focus articles like these each year. The SRTR Report on the State of Transplantation is a project that brings together a group of talented and dedicated people. As the guest editor, I am very privileged to work with each of them. Dr. Philip Halloran, Editor-in-Chief of the American Journal of Transplantation, has strongly supported our efforts since the inception of this report eight years ago. He has provided clear and very helpful guidance all along the way. Dellice Berezan and Gillian Hughes at the AJT editorial office kindly kept us on track through the entire peer-review process. We were saddened this year by the death of Pam Publicover, who provided the SRTR with many years of advice and assistance in her position at the AJT editorial office. She will be deeply missed. We have excellent and important relationships with Wiley-Blackwell, especially with Alison Labbate, Kate Heinle, Sharon Mathelus, Fadia Matouk, Kurt Polesky, Cathy Krendel and Chris Coia, each of whom has continued to facilitate the production and distribution of the report. We are grateful, as well, to proofreader Amy Rosenstein for her thorough and cheerful review. Our colleagues at the Division of Transplantation at HRSA are always extremely important partners in this effort. In particular, we are grateful to James Bowman, Richard Durbin, Chris McLaughlin, Monica Lin, Robert Walsh, Richard Laeng, Elizabeth Ortiz-Rios, Bernie Kozlovsky and Helen Li for their active participation, advice and encouragement. Our 62 authors, representing every area of clinical transplantation, completed their tasks with great professionalism. I am indebted to each of the authors for making and fulfilling their commitment to the SRTR Report on the State of Transplantation this year. Our lead authors committed particular time and care to their articles. This report simply wouldn't happen without the expertise, hard work, and passion of my colleagues at the Arbor Research Collaborative for Health and the University of Michigan. I thank the principals of the SRTR project, Drs. Robert A.Wolfe (Principal Investigator), Alan B. Leichtman, Akinlolu O. Ojo, Susan Murray, Douglas E. Schaubel, Jack D. Kalbfleisch, John C. Magee, Randall S. Sung, D. Bradley Dyke, Panduranga S. Rao, Shawn J. Pelletier, Amit K.Mathur, Michael J. Englesbe, Pratima Sharma and Silas P. Norman. Nearly all of the SRTR's analysts, programmers and administrative staff from the University of Michigan and Arbor Research contributed to this report, including Charlotte J. Arrington, Valarie B. Ashby, Andrew D. Barnes, David M. Dickinson, Melissa A. Fava, Douglas S. Fuller, Edward M. Green, Mary K. Guidinger, Benjamin H. Guidinger, Craig D. Lake,Maria Larkina, Gregory N. Levine, Jack Liao, Keith P. McCullough, Emily E. Messersmith, Kathryn H. Meyer, Nadirah N. Pitts, Katherine E. Pearson, Ying Qian, Ann M. Rodgers, Erik C. Roys, Robin Sands, Tempie H. Shearon, Sheetal A. Sonar, Diane E. Steffick, Randall L. Webb and James C. Welch. A few people especially stand out. Katherine Pearson is the project administrator for the SRTR team. With her calm and thorough attention, she always had her finger on the pulse of this project. Andrew D. Barnes responded to requests for special analyses and prepared the hundreds of reference tables that form the basis for these articles, supplying drafts to authors and incorporating their feedback. Caroline A. Shevrin, who took over last year as the senior editor for the project, assumed her new role seamlessly, expertly and with great enthusiasm and this year exceeded her own outstanding debut performance. She was ably assisted by Jennifer L. McCready-Maynes, Shauna A. Leighton and Heather M. Van Doren, who managed drafts and revisions of the articles from the editorial perspective, coordinated the peer-review process among coauthors, expertly edited text and graphics and ensured that a uniform stylistic approach was applied to each manuscript. Their remarkable skills and attention to detail contributed greatly to each article. This report is the product of hard work and dedication by everyone who participated in its creation. We hope that you find it informative and refer to it throughout the year.