Evidence map›Paper›PMID 27757587›Full record

ArticlePediatric nephrology (Berlin, Germany)2017

Poor outcomes for children on the wait list at low-volume kidney transplant centers in the United States.

Abbas Rana, Eileen D Brewer, Brandi B Scully, Michael L Kueht, Matt Goss, Karim J Halazun, Hao Liu, N Thao N Galvan, Ronald T Cotton, Christine A O'Mahony

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Article in Pediatric nephrology (Berlin, Germany), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Abbas RanaMichael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM390, Houston, TX, 77030, USA. abbas.rana@bcm.edu.
Eileen D BrewerDepartment of Pediatric Medicine, Division of Nephrology, Texas Children's Hospital, Houston, TX, USA.
Brandi B ScullyDepartment of Surgery, Division of Abdominal Transplantation, Texas Children's Hospital, Houston, TX, USA.
Michael L KuehtDepartment of Surgery, Division of Abdominal Transplantation, Texas Children's Hospital, Houston, TX, USA.
Matt GossDepartment of Surgery, Division of Abdominal Transplantation, Texas Children's Hospital, Houston, TX, USA.
Karim J HalazunDepartment of Surgery, Division of Abdominal Transplantation, Weill Cornell Medical Center, New York, NY, USA.
Hao LiuDan L. Duncan Cancer Center, Department of Biostatistics, Baylor College of Medicine, Houston, TX, USA.
N Thao N GalvanDepartment of Surgery, Division of Abdominal Transplantation, Texas Children's Hospital, Houston, TX, USA.
Ronald T CottonDepartment of Surgery, Division of Abdominal Transplantation, Texas Children's Hospital, Houston, TX, USA.
Christine A O'MahonyDepartment of Surgery, Division of Abdominal Transplantation, Texas Children's Hospital, Houston, TX, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLow case volume has been associated with worse survival outcomes in solid organ transplantation. Our aim was to analyze wait-list outcomes in conjunction with posttransplant outcomes.

methodsWe studied a cohort of 11,488 candidates waitlisted in the Organ Procurement and Transplantation Network (OPTN) for pediatric kidney transplant between 2002 and 2014, including both deceased- and living-donor transplants; 8757 (76 %) candidates received a transplant. Candidates were divided into four groups according to the average volume of yearly transplants performed in the listing center over a 12-year period: more than ten, six to nine, three to five, and fewer than three. We used multivariate Cox regression analysis to identify independent risk factors for wait list and posttransplant mortality.

resultsTwenty-seven percent of candidates were listed at low-volume centers in which fewer than three transplants were performed annually. These candidates had a limited transplant rate; only 49 % received a transplant versus 88 % in high-volume centers (more than ten transplants annually) (p < 0.001). Being listed at a low-volume center showed a fourfold increased risk for death while on the wait list [hazard ratio (HR) 4.0 in multivariate Cox regression and 6.1 in multivariate competing risk regression]. It was not a significant risk factor for posttransplant death in multivariate Cox regression.

conclusionsPediatric transplant candidates are listed at low-volume transplant centers are transplanted less frequently and have a much greater risk of dying while on the wait list. Further studies are needed to elucidate the reasons behind the significant outcome differences.

Indexed as

Waiting ListsAdolescentAge FactorsBody Mass IndexCause of DeathChildChild, PreschoolCohort StudiesCritical CareFemaleGraft SurvivalHumansInfantInfant, NewbornKidney Failure, ChronicKidney TransplantationCase volumePediatric kidney transplantPosttransplant survivalTransplant rateWaitlist survival

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.