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Program and OPO Specific Reports
, July 2010
Report Published
July 2010
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Full Report (PDF) for this center
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New York-Presbyterian Hospital/ Weill Cornell Medical Center, New York, NY(KP)
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| A Guide to Reading and Understanding the Center-Specific
Reports (CSRs) Prepared by the Scientific Registry of Transplant Recipients (SRTR) |
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| Center:
New York-Presbyterian Hospital/ Weill Cornell Medical Center (NYNY) |
| Organ:
KP: Kidney/Pancreas |
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| Overview: |
These Program-Specific Reports contain a wide range of useful information
about transplant programs operating in the United States. The information
includes many features of the transplant program, such as the number of
transplants performed in recent years, waiting time and waiting list
outcomes, and post-transplant experience of patients served by this program.
The statistics are arranged to allow comparisons to national averages, as
well as to the experience for similar patients at other programs in the
country. This report is based largely on data submitted by this transplant
program for patients on the waiting list and those transplanted within the
last five years. |
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Table 1 provides a picture of the volume and type of waiting list and
transplant activity at this program. New York-Presbyterian Hospital/ Weill
Cornell Medical Center (NYNY) had 24 patients on its waiting list on
01/01/2008 and 22 patients on 12/31/2009. During these two years, 39 patients
were added to the list and 41 patients were removed. Of the removals, 10 were
for transplant from a living donor and 18 were for transplant from a deceased
donor. New York-Presbyterian Hospital/ Weill Cornell Medical Center (NYNY)
performed 9 kidney-pancreas transplants (Table 7) during the last year
(01/01/2009-12/31/2009). Typical kidney-pancreas programs currently operating
in the United States transplanted between 2 and 11 people in that same
period. More about the activity at this program and the types of patients
served is found in the Table Details section below and in Tables 1 and 2
(waiting list) and Tables 7, 8, and 9 (transplant). |
Waiting times for transplantation differ from facility to facility and also
from person to person, depending upon many factors. Half of the patients
listed at this program had received a transplant as of 10.0 months after
being placed on the waiting list; in the nation it took 13.6 months to reach
the same fraction of patients transplanted. The other half of the patients
were either still waiting or removed from the waiting list for reasons
including death. Tables 3 through 5, which focus on other characteristics of
waiting list and waiting time (including risk-adjusted comparisons) are
discussed in the details section below. |
At New York-Presbyterian Hospital/ Weill Cornell Medical Center (NYNY),
83.33 percent of adult patients were alive one year after transplant,
compared to the 95.97 percent that would be expected based on the
characteristics of these patients. However, the p-value of 0.131 indicates
that the difference between these rates is not statistically significant.
Similar comparisons may be made for shorter- (1 month) and longer-term (3
year) survival, also in Table 11, as well as for graft survival (Table 10).
Further discussion of actual, expected, and national survival rates may be
found in the Table Details section below. |
Specific circumstances at each program may affect many of the measures
reported in these reports. Frequently, staff from transplant programs make
public comments regarding these reports, made available in the comments page.
We encourage all readers of these reports to consider these comments and to
contact the program directly for further information. |
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Table Details: |
The above overview provides most readers with a quick look at some of the
statistics that help describe a transplant program. The following section,
for the more interested reader, provides a more detailed accounting of each
table and how figures are defined and calculated. |
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Tables 1 through 6 focus on characteristics of the waiting list process at
this program. Table 1 provides an overview of the waiting list activity at
this program: not just the size of the waiting list at a given point in time,
but also how many people have moved on to and off of this waiting list, and
for what reasons. Shown as a percentage of the total waiting list size on
01/01/2009, the percent of people removed for a transplant from a deceased
donor was 55.6%, (vs. 39.9% nationwide) and the percentage of people removed
because of death was 16.7% (vs. 7.1% nationwide). Table 2 shows the
characteristics of patients on the waiting list at New York-Presbyterian
Hospital/ Weill Cornell Medical Center (NYNY). |
The waiting time at a given transplant program is affected by many factors,
including the medical condition and characteristics of the patients listed
with this program (Table 2), the availability of organs in the Donation
Service Area served by the OPO, and decisions by medical professionals and
other patients about organ acceptance. Some of the variability in waiting
time may be accounted for by local availability of organs, in which case
other programs in the Donation Service Area served by New York Organ Donor
Network may have similar waiting times. |
Tables 3 through 6 provide different measures of looking at waiting list
outcomes. Table 3 shows a 'risk-adjusted' comparison of two outcomes from the
waiting list: transplant rate and death rate. While the national average
transplant rate (from deceased donors) is 0.40 transplants per patient year,
the rate expected for this program is 0.41. The difference, or 'adjustment',
between the national average and expected rate is caused by the fact that
this program may treat patients who typically have longer (or shorter)
waiting times, based on the characteristics of these patients. The patients
on the waiting list at this program experienced a transplant rate of 0.54 per
year spent on the waiting list for any person(s) on the waiting list. Compared
to the expected rate of 0.41, the difference is not statistically significant
(p>.05); there is a good possibility that it is due to random chance. |
These waiting list rates are measured as the number of transplants (or
deaths) per year that any patient spends on the waiting list. It is possible
for these rates to be above 1, as would be the case if 2 patients each spent
3 months on the waiting list, and one received a transplant: 1 transplant
divided by .5 year = transplant rate of 2. |
While Table 3 provides a waiting list outcome rate that allows easy
comparison of risk-adjusted outcomes, statistics from tables 4 through 6 may
be more interpretable at a patient level. Table 4 answers the questions:
'What has been the outcome for patients at this program 6 months after being
placed on the waiting list? What about at 12 or 18 months?' The table also
examines post-transplant outcomes: at 12 months, for example, the table tells
if the patient is still on the waiting list, was transplanted and is still
alive, or died after transplant. At this program, 50.0% of patients had
received a transplant by 6 months after being placed on the waiting list,
compared with 30.5% in the nation (Table 4). At 6 months, 0.0% had died
(compared to 2.9% nationally) and 50.0% were still on the waiting list (63.9%
nationally). Note that these figures are not adjusted for patient
characteristics. |
Table 5 provides another way to look at how quickly patients receive
transplants at this program, this time looking at many different kinds of
patients. At this program, 0.0 percent of patients placed on the
kidney-pancreas waiting list had received transplants as of 30 days after
being placed on the waiting list. Those not transplanted, the other 100.0
percent, were either still waiting or removed from the waiting list for
reasons including death. At one year after placement on the waiting list,
24.2 percent of patients at this program had been transplanted; this figure
was 38.2 for all the programs in the nation. The table also shows similar
figures for subgroups of patients, such as by age, disease, or medical
urgency, allowing the reader to see if specific groups of patients have
experienced longer waiting times. |
Table 6 shows the time it takes for a given percentage of patients at this
facility to receive a transplant. This is the 'time-to-transplant' among all
wait-listed patients, including those who never receive a transplant. Half of
the patients placed on the waiting list at this program had received a
transplant as of 10.0 months after listing; in the nation it took 13.6 months
to reach the same fraction. The other half of the patients were either still
waiting or removed from the waiting list, for reasons including death.
(Another common statistic, 'median waiting time,' differs in that it is often
calculated only among patients who actually received a transplant. The two
are often correlated, but different in magnitude. While median waiting time
reflects time waiting among successful candidates, time-to-transplant
incorporates a measure of the probability of success in receiving an organ.) |
The remainder of the tables, 7 through 11, focus on transplants performed
at New York-Presbyterian Hospital/ Weill Cornell Medical Center (NYNY) and
their outcomes. Tables 7-9 describe the characteristics of transplant
recipients, donors, and operations at this program. |
Tables 10 and 11 show post-transplant outcomes. Table 10 shows the survival
experience of grafts (transplants) in patients transplanted by this program.
Table 11 shows the survival experience of these patients themselves. These
may be different because a patient may continue survival after a graft fails
through means such as a new transplant, or, for kidney patients, dialysis.
For each outcome, these tables show an actual (observed) survival for the
program, an actual (observed) survival for the nation, and an expected
survival for the program. Each survival number measures the percentage of
patients who have a functioning graft (Table 10) or who are alive (Table 11)
at 1 month, 1 year, and 3 years after transplant. |
The expected survival rate for a given program is the percentage of grafts
functioning (or patients alive) that would be expected for the patients
served by this program, given their characteristics (age, disease, blood
type, etc.) and the experience of similar patients in the entire country. At
this program, the expected one-year patient survival rate of 95.97 may be
different from the national average of 96.04 if patients transplanted at this
program have characteristics that would make us expect a different survival
rate than the average. |
At New York-Presbyterian Hospital/ Weill Cornell Medical Center (NYNY),
83.33 percent of adult patients were alive one year after transplant,
compared to the 95.97 percent that would be expected based on the
characteristics of these patients. However, the p-value of 0.131 indicates
that the difference between these rates is not statistically significant.
Similar comparisons may be made for shorter- (1 month) and longer-term (3
year) survival, also in Table 11, as well as for graft survival (Table 10).
Further discussion of actual, expected, and national survival rates may be
found in the Table Details section below. |
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