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1992.09.15 :  Report -- Patient and Graft Survival Rates

Contact:  Charlotte Mehuron (301) 443-3376
September 15, 1992

       HHS Secretary Louis W. Sullivan, M.D., today released the
first national hospital-by-hospital report on patient and graft
survival rates for kidney, heart, lung, liver and pancreas
transplants for patients, their families and physicians to use in
the selection of transplant options.
       "This report documents for the first time the success of
transplant technology on a hospital-by-hospital basis," said
Secretary Sullivan.  "In the case of kidney transplants--the most
common procedure--92.9 percent of patients were alive one year
after surgery."
       Other data showed that after one year the percent of
transplant patients living was:  88.7 percent for pancreas, 82.l
percent for heart, 74.4 percent for liver, 53.3 percent for heart-
lung and 53.9 percent for lung.
       The 1,400-page Transplant Center-Specific Patient and Graft
Survival Report, required by the Transplant Amendments of 1990,
Section 372 of the Public Health Service Act, compares a center's
organ and patient survival rate against the national average based
on center-verified transplant outcomes from Oct. 1, 1987, to
Dec. 31, 1989.
       Survival rates on almost 29,000 transplants performed at 252

hospitals nationwide, with a total of 531 hospital-based, organ-
specific transplant services, are reported to be similar at most 
transplant centers throughout the country when adjustments are made
for number of transplant procedures; underlying condition; type of
donor (living or deceased); patient age, sex and race; and, to
allow for transplant technology advances, the transplant date.
       The Organ Procurement and Transplantation Network is
operated by the United Network for Organ Sharing, of Richmond, Va.,
under contract with the Health Resources and Services
Administration.  The OPTN is required to report to the HHS
secretary on patient outcomes at affiliated transplant centers and
to make the information available to patients and their families to
use in selecting a transplant center.
       The data in today's report were collected and verified by
UNOS and are organized by type of transplant, by transplant center
and by state.  The report gives each center's actual survival rate
and expected survival rate, adjusted for each organ by patient risk
factors which might impact a center's survival rate.
       For this first study, risk factors included whether the
donor was living or deceased, the recipient's overall health at the
time of transplant, demographic information and whether the
transplant was a first or repeat transplant.  Other risk factors,
such as whether a patient is diabetic, will be used in future
reports.
       The methodology used in the report was developed by the UNOS
Scientific Advisory Committee, made up of transplant patients and
surgeons, epidemiologists and biostatisticians, in consultation
with HRSA, the Health Care Financing Administration and the Agency
for Health Care Policy and Research.

       "Significant numbers of lives can be saved with organ
transplants," said Assistant Secretary for Health James Mason,
M.D., who is head of the Public Health Service.  "In the process of
reviewing the data, we must keep in mind the critical need for
organ donors.  Thousands of people urgently and anxiously await
donated organs."
       The report has been sent to all 531 transplant programs and
to 69 organ procurement organizations certified by the Health Care
Financing Administration for Medicare and Medicaid reimbursement
for organ recovery.  The procurement organizations evaluate
potential donors to determine if they meet the legal and medical
criteria for organ donation.  If they do, the organization
discusses the option of organ donation with families.
       HRSA Administrator Robert G. Harmon, M.D., M.P.H., cautioned
that while "this is the most scientific and valid analysis of
transplant procedures to date, future studies including other
important risk factors are expected to produce better measures of
actual or expected survival rates."  Harmon stressed that the
information should only be used along with other considerations,
such as the experience of transplant teams; the cost and
accessibility of services; and the availability of support services
before, during and following transplantation.
       More than 97 percent of the data were validated by the
transplant centers and extreme care was taken to ensure fair and
accurate data collection and analysis.  Each center was invited to
include a one-page narrative on unique patient and graft 
characteristics affecting survival such as illness severity,
population demographics or case-mix.
       The Health Resources and Services Administration is one of
eight Public Health Service agencies in the Department of Health
and Human Services.
     The report is a four-volume set, plus executive summary and
user's guide. The full set includes:

          User's Guide - 12 pages
          Executive Summary - 86 pages
          Kidney Data - 548 pages
          Heart, Heart-Lung and Lung Data - 481 pages
          Liver Data - l82 pages
          Pancreas Data - 122 pages          

       To purchase a full set or individual volumes, call the
National Technical Information Services at 703-487-4650.

       For phone numbers and addresses of transplant centers or
organ procurement organizations, call the United Network for Organ
Sharing at 804-330-8500.

       Patients and physicians may call toll free l-800-243-6603
(or l-800-24-DONOR) for information on up to 10 transplant
programs.


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