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Kidney

OPTN/SRTR 2019 Annual Data Report: Kidney

Abstract

Despite the ongoing severe shortage of available kidney grafts relative to candidates in need, data from 2019 reveal some promising trends. After remaining relatively stagnant for many years, the number of kidney transplants has increased each year since 2015, reaching the highest annual count to date of 24,273 in 2019. The number of patients waiting for a kidney transplant in the United States was relatively stable, despite an increase in the number of new candidates added in 2019 and a decrease in patients removed from the waiting list owing to death or deteriorating medical condition. However, these encouraging trends are tempered by ongoing challenges. Nationwide, only a quarter of waitlisted patients receive a deceased-donor kidney transplant within 5 years, and this proportion varies dramatically by donation service area, from 15.5% to 67.8%. The non-utilization (discard) rate of recovered organs remains at 20.1%, despite a dramatic decline in the discard of organs from hepatitis C-positive donors. Non-utilization rates remain particularly high for Kidney Donor Profile Index ≥85% kidneys and kidneys from which a biopsy specimen was obtained. While the number of living-donor transplants increased again in 2019, only a small proportion of the waiting list receives living-donor transplants each year, and racial disparities in living-donor transplant access persist. As both graft and patient survival continue to improve incrementally, the total number of living kidney transplant recipients with a functioning graft is anticipated to exceed 250,000 in the next 1-2 years.

Over the past decade, the total number of pediatric kidney transplants performed has remained stable. Despite numerous efforts, living donor kidney transplant remains low among pediatric recipients with continued racial disparities among recipients. Congenital anomalies of the kidney and urinary tract remain the leading cause of kidney disease. While most deceased donor recipients receive a kidney from a donor with KDPI less than 35%, the majority of pediatric recipients had four or more HLA mismatches. Graft survival continues to improve with superior outcomes for living donor recipients.

Introduction

Kidney transplant provides significantly more quality-of-life and survival benefits than dialysis for the treatment of end-stage kidney disease, but maximizing access to transplant, reducing access disparities, and sustaining long-term allograft survival are ongoing challenges. A national urgency to increase access to kidney transplant received unprecedented support from the federal government in the July 2019 Advancing American Kidney Health Executive Order and ensuing national policy initiatives. The Annual Data Report is an opportunity to assess the state of kidney transplant and examine both positive patterns and unfavorable trends that warrant further monitoring and evaluation. Data are provided on adult and pediatric kidney transplant waiting lists, deceased and living donation, transplants, and outcomes.

Adult Kidney Transplant

Waiting List

In 2019, the number of candidates added to the waiting list surpassed that of 2018 (Figure KI 1, Table KI 5). Despite this increase in waiting list additions, the total number of patients on the list remained essentially stable, as it had for the last 4-5 years, following decades of steady annual increases (Figure KI 2, Table KI 5). The size of the waiting list remained stable, despite an increase in additions, due to an increase in both living and deceased donor transplants. Waiting list removals due to death or deteriorating medical condition declined in 2019 (Table KI 6). The trend of a gradual increase in the age of candidates on the waiting list over the last 10 years persisted (Figure KI 3). Candidates 50-64 years old remained the largest age-group on the waiting list, and the proportion of candidates aged ≥65 years continued to rise (Figure KI 3, Table KI 1). Men continued to comprise about 60% of the waiting list (Figure KI 4). Over the past 10 years, the proportion of Asian and Hispanic candidates gradually increased, accompanied by a decline in the proportion of white candidates (Figure KI 5). The proportion of candidates with a primary diagnosis of diabetes continued to rise, reaching 37.7% in 2019 (Figure KI 6).

Reflecting the increase in waiting list additions, the proportion of candidates prevalent on the wait list and waiting less than 1 year continued to increase in 2019 and now comprises greater than half of waitlisted candidates, while 10.4% on the waitlist on January 1, 2019 have been waiting ≥5 years (Figure KI 7). The proportion of candidates with high body mass index (BMI) also continued to increase, to more than a quarter of waitlisted candidates with a BMI of 30 to <35 kg/m2 and 17.8% with a BMI of ≥ 35 kg/m2 (Figure KI 8). Encouragingly, the proportion of candidates waitlisted before starting dialysis continued to increase, although 17% of those waitlisted had been on dialysis for 6 or more years (Figure KI 9). More than half of waitlisted candidates had blood type O, which remains the most common type (Figure KI 10). Nearly 12% of candidates had a previous transplant, a slight decline over the past decade (Figure KI 11).

The proportion of candidates willing to accept a high-Kidney Donor Profile Index (KDPI) kidney was relatively stable in 2019 compared to 2018, following a decline after implementation of the revised Kidney Allocation System (KAS) in December 2014 (Figure KI 12). Still, less than half of candidates aged 50-64 and less than two-thirds of candidates aged ≥65 years were willing to accept these kidneys (Figure KI 12), even though older patients are less likely than younger patients to undergo kidney transplant under the current KAS. Conversely, the proportion of candidates willing to accept a kidney from a hepatitis C virus (HCV)-positive donor steadily increased, correlating with availability of highly effective direct-acting antiviral agents (DAAs) and experience using DAAs to manage anticipated donor-derived infections (Figure KI 13). To date, the information on willingness to accept HCV-positive kidneys does not differentiate between donor HCV antibody (exposed) and nucleic acid (viremic) status.

Overall, deceased-donor kidney transplant (DDKT) rates rose again in 2019, after reaching a nadir in 2014 (Figure KI 14). This increase was noted across all age (Figure KI 15), racial, and ethnic groups (Figure KI 16). DDKT rates have been similar for white, black, and Hispanic patients after implementation of the revised KAS; however, rates remained lower for Asian candidates than for those of other ethnicities (Figure KI 16). DDKT proportions by calculated panel reactive antibody levels (cPRAs) remained dynamic in 2019, after a sharp increase in DDKT rates among patients with cPRAs of 98%-100% immediately after implementation of the revised KAS; the rate subsequently plateaued in this group and was similar to the rates among patients in most other cPRA groups in 2019 (Figure KI 18). The DDKT rate remained slightly higher in patients with cPRAs of 80%-98%, at 20.8 transplants per 100 waitlist-years, compared with 14.4-16.7 transplants per 100 waitlist-years in the other cPRA groups (Figure KI 18). DDKT rates have increased more in blood type AB patients over the past 5 years than in those with blood types A, B, and O (Figure KI 19); rates have not increased in blood type B candidates relative to other blood types despite the revised KAS allowing allocation of A2 and A2B kidneys to B candidates. In 2019, DDKT rates increased across the spectrum of waiting times, although the rise continued to be largest among patients on the waitlist for more than 5 years, likely reflecting the credit, under the KAS revision, allocated for time on dialysis before waitlisting (Figure KI 20). DDKT rates were nearly identical between men and women in 2019 (Figure KI 21) and remained slightly higher among residents of non-metropolitan than metropolitan areas Figure KI 22).

For patients waitlisted in 2016, 36.5% were still waiting in 2019; 23.0% had undergone DDKT,13.5% had undergone living-donor kidney transplant (LDKT), 6.8% died, and 20.1% were removed from the waiting list (Figure KI 23). Among candidates listed in 2018, 16.8% of underwent DDKT within 1 year, and 25.3% of those listed in 2016 underwent DDKT within 3 years. Among candidates listed in 2014, 27.7% underwent DDKT within 5 years, and 34.4 % of those listed in 2009 underwent DDKT within 10 years (Figure KI 24). The median time to transplant for candidates has not been calculable for more than a decade, because 50% of candidates on the waiting list have not undergone transplant since 2008. The proportion of patients listed in 2014 who underwent DDKT within 5 years continued to vary greatly by donation service area (DSA), from 15.5% in locations with long waiting times to 67.8% in regions with shorter waiting times (Figure KI 25). Notably, pretransplant mortality continued a downward trend in 2019, reaching its lowest point in 10 years across age, race and ethnicity, sex, reasons for kidney failure, blood-type and metropolitan/non-metropolitan residence (Figure KI 27, Figure KI 28, Figure KI 29, Figure KI 30, Figure KI 31, Figure KI 32, Figure KI I 33), as well as among both active and inactive waitlisted patients (Figure KI 34). However, waiting list mortality also varied greatly by region, from 1.29 to 7.02 deaths per 100 waitlist-years (Figure KI 35). Deaths within 6 months of removal from the waiting list increased in 2019, but this increase was a return to rates seen in 2016 and before (Figures KI 36, Figure KI 37, Figure KI 38) and, therefore, may not necessarily reflect a change in practices for removing patients deemed too sick to undergo transplant.

Deceased Donation

In another positive trend, the count of deceased donors from whom at least one kidney was recovered continued to increase in 2019 (Figure KI 39), particularly among donors aged 30 years and older (Figure KI 40). Reflecting the availability of DAAs for HCV, the count and proportion of HCV-positive deceased donors from whom kidneys were recovered also increased in 2019 (Figure KI 41, Figure KI 45). The sex, race, and ethnicity distribution of deceased kidney donors remained largely unchanged over the past decade (Figure KI 43, Figure KI 44). The proportion of deceased-donor kidneys recovered but not transplanted remained at 20.1% in 2019, despite the persistent unmet need for transplants among some candidates on the waiting list (Figure KI 47). Rates of non-utilization were highest for kidneys recovered from donors ≥55 years old (Figure KI 48) and those with diabetes, hypertension, or high BMI (Figure KI 49, Figure KI 52, Figure KI 53). Recovered kidneys from which biopsies were obtained continued to have stable but high rates of discard (Figure KI 55), despite a lack of evidence that biopsy findings correlate well with posttransplant outcomes. The proportion of recovered but discarded HCV-positive kidneys continued to decline sharply starting in 2014; notably, in 2019, HCV-antibody-positive kidneys were discarded at nearly the same rates as HCV-antibody-negative kidneys (Figure KI 57). A slightly lower proportion of kidneys with increased infection risk were discarded than those with standard infection risk, perhaps because kidneys with high infection risk are often otherwise of high quality and low KDPI (Figure KI 58). KDPI >85% kidneys continued to represent most discarded kidneys (Figure KI 60). However, the average Kidney Donor Risk Index (KDRI) of discarded kidneys continued to rise in 2019 (Figure KI 62), suggesting that high-quality kidneys were not being discarded. The proportion of kidneys recovered from patients who died of anoxia continued its linear increase in 2019, amid the ongoing opioid epidemic (Figure KI 64).

Living Donation

After a steady decline in living donation from 2005 to 2014 followed by a plateau, the number of LDKTs increased progressively from 2017 to 2019, reaching the highest annual count to date of 6,867 (Figure KI 74). While reflecting important progress, only a small proportion of the waiting list undergoes LDKT each year. Future years will reveal whether this upward trajectory will continue, although the disruption of LDKT practice related to the COVID-19 pandemic in 2020 must be considered in the assessment of next year’s trends. The proportion of donors aged ≥ 55 years continued to rise, correlating with improved procedural safety and increased concern for the long-term risks of kidney donation in some younger adults (Figure KI 66). In 2019, the proportion of living kidney donors that were female rose to a peak of 65.2% (Figure KI 67). The racial and ethnic composition of living donors in 2019 was stable compared with 2018, with 70.7% white, 14.5% Hispanic, and 8.8% black, although this reflects a decline in the proportion of Black living donors, from 12.0% in 2010 (Figure KI 68). Similar to recent years, 22.8% of living donors were obese, based on BMI >30 kg/m2 (Figure KI 72). Reported complications and hospitalizations after living-donor nephrectomy were uncommon (Figure KI 70, Figure KI 71).

Transplants

After remaining relatively stagnant for many years, the number of kidney transplants increased each year starting in 2015, reaching the highest annual count to date of 24,273 in 2019 (Figure KI 73). Increases occurred across recipient age, sex, race, and cause of kidney disease (Figure KI 75, Figure KI 76, Figure KI 77, Figure KI 78). Demographic differences in transplant recipients by organ donor type are notable, including persistent disparities in access to LDKT. While 31.5% of waitlisted candidates were Black (Figure KI 5), Black patients comprised only 13.1% of LDKT recipients, versus 32.8% of DDKT recipients in 2019 (Table KI 8). White patients comprised 37.9% of the waiting list (Figure KI 5) but made up 63.9% of LDKT recipients and 38.0% of DDKT recipients (Table KI 8). Most LDKT recipients (54.0%) had private insurance at the time of transplant, while 67.7% of DDKT recipients were Medicare beneficiaries (Table KI 8). LDKT recipients tended to have less dialysis time and lower cPRAs than DDKT recipients (Table KI 9). Proportions of DDKTs versus LDKTs were similar by metropolitan and non-metropolitan place of residence and distance from transplant centers (Table KI 8) and similar to the proportions of these characteristics among waiting list patients on Dec 31, 2019 (Table KI 1). Nearly 90% of DDKTs and 90.8% of LDKTs were performed in first-time recipients (Table KI 10). In 2019, 7.2% of deceased donors with at least one kidney transplanted were HCV antibody-positive, and 4.5% were HCV nucleic acid-positive (Table KI 11). Among living donors, 0.6% were positive for HCV antibodies (Table KI 12).

The proportion of DDKTs classified as low KDPI (0%-<20%) declined over the past 3 years, to 22.6% in 2019, while the proportion of DDKT classified as KDPI 35%-85% rose to 53.3%, and KDPI ≥85% transplant remained stable, at 7.6% (Figure KI 79). The number of simultaneous kidney-liver transplants in adults more than doubled from 354 in 2009 to 723 in 2016, and has remained at that level since 2016 (Figure KI 80). Induction immunosuppression was used in 91.9% of kidney transplants (Figure KI 81). The choice of maintenance immunosuppression at hospital release remained stable, with most patients receiving tacrolimus and mycophenolate mofetil-based regimens (Figure KI 82). Nearly 30% received steroid-free regimens, a relatively stable proportion, over the past decade. As noted previously, the proportion of DDKTs in recipients with cPRAs of 98%-100% increased sharply after the KAS revision and then gradually declined, from 12.5% in 2015 to 7.8% in 2019 (Figure KI 83). As practice volume expanded, the proportion of transplants performed at centers with volume of at least 250 transplants per year grew sharply over the past 5 years, from 13.8% in 2014 to 31.6% in 2019 (Figure KI 87).

Outcomes

Estimated glomerular filtration rate at 12 months, an early surrogate allograft outcome, was 45 mL/min/1.73m2 or higher for 65.5% of DDKT recipients (Figure KI 105) and 77.7% of LDKT recipients (Figure KI 106) in 2018. Overall, 7.0% of adult kidney transplant recipients experienced acute rejection by 1 year, including 9.1% of recipients aged 18-34 and 6.1% of recipients ≥65 years (Figure KI 108). Acute rejection at 1 year occurred in 8.4% of those who received interleukin-2 (IL-2)-receptor antibody induction, compared with 6.9% who received T-cell-depleting induction and 6.6% of the small subgroup whose conditions were managed without induction (Figure KI 109).

Death-censored graft failure after DDKT remained stable in 2018 compared with 2017 (Figure KI 89). In the most recent reporting year, 6-month and 1-year LDKT death-censored graft failure was stable, while 3- to 10-year graft survival showed small improvements (Figure KI 92). For both donor types, 5-year graft survival was lowest among patients with diabetes as the cause of kidney disease (Figure KI 95, Figure KI 103). For both donor types, graft survival was similar in recipients who resided in metropolitan compared to non-metropolitan ZIP codes (Figure KI 100, Figure KI 104).

Among DDKTs, 5-year graft survival was 64.6% with KDPI >85% compared with 83.9% with KDPI ≤20%, and 82.1% with KDPI 21%-35% (Figure KI 96). Five-year graft survival did not differ by donor type after circulatory death (Figure KI 97). Graft survival was lower for kidneys from which biopsy specimens were obtained at transplant (Figure KI 98); while selection likely contributes to this difference, as noted previously, the utility of procurement biopsy in informing appropriate organ use warrants further study. Among LDKT recipients, 5-year graft survival was 80.2% in those aged ≥65 years, compared with 90.7% in recipients aged 35-49 years (Figure KI 101). 5-year living donor graft survival was highest among Asians and lowest among Blacks (Figure KI 102).

The total number of kidney transplant recipients alive with a functioning graft, including pediatric recipients, reached 244,000 in 2019, part of a trend that will likely exceed 250,000 in the next 1-2 years (Figure KI 107). Trends in adult patient survival closely mirrored those of graft survival (Figure KI 113, Figure KI 114, Figure KI 115, Figure KI 116, Figure KI 117, Figure KI 118, Figure KI 119, Figure KI 120, Figure KI 121).

Pediatric Kidney Transplant

Waiting List

In 2019, 1030 pediatric candidates were added to the kidney transplant waiting list (Figure KI 122). The number of prevalent pediatric candidates (listed before age 18 years) has been steadily increasing and reached 2579 in 2019 (Figure KI 123). By age, candidates aged 12-17 years accounted for the largest proportion of those waiting, at 58.4%, compared to those aged 6-11 years at 20.7%, and younger than 6 years at 20.9% (Figure KI 124). Over the past decade, the age of pediatric waitlist candidates has shifted, with a slight increase for those aged 1-5 and 6-10 years and a slight decrease for those aged 11-17 years (Figure KI 124, Table KI 14). Proportions of candidates with congenital anomalies of the kidney and urinary tract (CAKUT) as primary cause of disease increased from 27.2% in 2009 to 37.2% in 2019, and proportions with glomerulonephritis and focal segmental glomerulosclerosis (FSGS) decreased (Table KI 15). Almost 70% of pediatric candidates waiting as of December 31, 2019, had a cPRA less than 1% (Table KI 15). The proportion of pediatric candidates waiting for re-transplant decreased over the decade from 26.6% in 2009 to 13.4% in 2019 (Table KI 16). Multi-organ listing remained uncommon; only 1.4% of pediatric candidates were awaiting multi-organ transplant at the end of 2019 (Table KI 16).

Sixty-five percent of pediatric candidates on the waiting list had been waiting for less than 1 year (Figure KI 128). Of the 1024 candidates removed from the waiting list in 2019 (Table KI 17), 610 (59.6%) received a deceased donor kidney, 262 (25.6%) received a living donor kidney, 18 (1.8%) died, 6 (0.1%) were removed from the list because their condition improved, and 10 (0.1%) were considered too sick to undergo transplant (Table KI 18). Among patients newly listed in 2016, 51.7% underwent deceased donor transplant within 3 years, 24.5% underwent living donor transplant, 14.2% were still waiting, 8.3% were removed from the list for other reasons, and 1.3% died (Figure KI 130). The rate of deceased donor transplant among pediatric waitlisted candidates decreased over the past decade to 38.5 transplants per 100 waitlist-years in 2019, compared with a peak of 52.0 transplants per 100 waitlist-years in 2009 (Figure KI 131). Post-KAS, transplant rates changed based on recipient age (Figure KI 132). In 2019, transplant rates were highest for candidates aged 6-11 years (48.8 per 100 waitlist-years), followed by candidates aged 1-5 years (37.4), 12-17 years (36.0), and younger than 1 year (15.0), though the rate among candidates younger than 1 is variable due to small numbers of transplants performed on this age group (Figure KI 132). The KAS priority for highly sensitized candidates continued to result in higher transplant rates than pre-KAS for highly sensitized pediatric candidates in 2019 (Figure KI 134). In contrast to mortality among candidates waiting for other organs, pretransplant mortality among pediatric kidney transplant candidates remained low: 1.2 deaths per 100 waitlist-years in 2019 (Figure KI 136).

Transplant

The total number of pediatric kidney transplants performed remained steady in 2019 at 763 (Figure KI 140). The continued decrease in living donor kidney transplants is of great concern of the pediatric community. In 2019, only 32% of pediatric kidney transplants were from living donors (Figure KI 141). The number of related living donors decreased dramatically over the past decade, but the number of unrelated directed transplants performed in pediatric candidates reached its highest at 73 in 2019 (Figure KI 143). Children aged younger than 6 years made up the largest group of living donor kidney recipients (47.0%) (Figure KI 144).

In 2019, 34 programs were performing only pediatric kidney transplants, compared with 135 performing only adult transplants and 59 performing transplants in both adults and children (Figure KI 145). In 2019, 15.1% of transplants in candidates aged younger than 18 years were performed at programs with volume of five or fewer pediatric transplants in that year (Figure KI 146). Most pediatric recipients who underwent transplant between 2017 and 2019 were aged 11-17 years, 61.4% among deceased donor recipients and 49.3% among living donor recipients (Table KI 19). The racial distribution differed for deceased and living donor transplant recipients; 69.7% of living donor recipients were white, 8.5% were black, 16.5% were Hispanic, and 3.3% were Asian. In contrast, 36.6% of deceased donor recipients were white, 22.6% were black, 32.7% were Hispanic, and 4.7% were Asian (Table KI 19). Private insurance was more common among living donor recipients (55.3%) and Medicare/Medicaid among deceased donor recipients (66.7%, Table KI 19). Most deceased donor recipients (95.8%) underwent transplant with a kidney from a donor with KDPI less than 35% (Table KI 21). The majority of pediatric recipients of a deceased donor kidney, 84%, had four or more HLA mismatches compared with only 27% of living donor recipients (Figure KI 149).

The combination of a donor who was positive for cytomegalovirus and a pediatric recipient who was negative occurred in 37.7% of deceased donor transplants (Table KI 22) and in 30.7% of living donor transplants (Table KI 23). The combination of a donor who was positive for Epstein-Barr virus (EBV) and a pediatric recipient who was negative occurred in 38.2% Table KI 22) of deceased donor transplants and in 52.5% of living donor transplants (Table KI 23).

Immunosuppressive Medication Use

Almost all (95.6%) pediatric kidney transplant recipients reported some induction use in 2019 (Figure KI 147). The most common maintenance immunosuppression regimens at hospital discharge were tacrolimus, MMF, and steroids in 59.5% of recipients, followed by tacrolimus and MMF in 33.2% (Figure KI 148).

Outcomes

All-cause graft failure after kidney-alone deceased donor transplant in pediatric recipients was 1.2% at 6 months and 1.6% at 1 year for transplants in 2017-2018, 6.3% at 3 years for transplants in 2015-2016, 15.8% at 5 years for transplants in 2013-2014, and 35.4% at 10 years for transplants in 2009-2010 (Figure KI 153). Corresponding graft failure after living donor transplant was 0.8% at 6 months and 0.8% at 1 year for transplants in 2017-2018, 3.3% at 3 years for transplants in 2015-2016, 5.7% at 5 years for transplants in 2013-2014, and 25.0% at 10 years for transplants in 2009-2010 (Figure KI 156). For the cohort of recipients who underwent transplant in 2012-2014, 1- and 5-year graft survival was 95.7% and 83.2% for deceased donor recipients and 96.9% and 91.4% for living donor recipients (Figure KI 161). In the 2017-2018 cohort, the overall incidence of acute rejection within the first year was 11.1%, with some variation by age: lowest for those aged 6-10 years (8.2%) (Figure KI 162). Short-term renal function, measured by eGFR, improved substantially over the past decade. Proportions of living donor and deceased donor recipients from 2018 with eGFR 90 mL/min/1.73 m2 or higher at 12 months posttransplant were 26.7% (increased from 19.7% in 2008) and 31.9% (increased from 22.3%), respectively (Figure KI 151, Figure KI 150). Incidence of posttransplant lymphoproliferative disorder among EBV-negative recipients from 2007-2017 was 3.5% at 5 years posttransplant, compared with 0.8% among EBV-positive recipients (Figure KI 163). Overall 5-year patient survival among pediatric deceased donor kidney transplant recipients in 2012-2014 was very high, at 97.1% (Figure KI 165) with little variability by age (Figure KI 166).

Figure List

Waiting list

Figure KI 1. New adult candidates added to the kidney transplant waiting list
Figure KI 2. All adult candidates on the kidney transplant waiting list
Figure KI 3. Distribution of adults waiting for kidney transplant by age
Figure KI 4. Distribution of adults waiting for kidney transplant by sex
Figure KI 5. Distribution of adults waiting for kidney transplant by race
Figure KI 6. Distribution of adults waiting for kidney transplant by diagnosis
Figure KI 7. Distribution of adults waiting for kidney transplant by waiting time (years)
Figure KI 8. Distribution of adults waiting for kidney transplant by BMI
Figure KI 9. Distribution of adults waiting for kidney transplant by years on dialysis
Figure KI 10. Distribution of adults waiting for kidney transplant by blood type
Figure KI 11. Distribution of adults waiting for kidney transplant by prior transplant status
Figure KI 12. Adults willing to accept a kidney designated ECD or KDPI > 85% by age
Figure KI 13. Adults willing to accept kidney from HCV+ donor
Figure KI 14. Overall deceased donor kidney transplant rates among adult waitlist candidates
Figure KI 15. Deceased donor kidney transplant rates among adult waitlist candidates by age
Figure KI 16. Deceased donor kidney transplant rates among adult waitlist candidates by race
Figure KI 17. Deceased donor kidney transplant rates among adult waitlist candidates by diagnosis
Figure KI 18. Deceased donor kidney transplant rates among adult waitlist candidates by C/PRA
Figure KI 19. Deceased donor kidney transplant rates among adult waitlist candidates by blood type
Figure KI 20. Deceased donor kidney transplant rates among adult waitlist candidates by time on the waitlist
Figure KI 21. Deceased donor kidney transplant rates among adult waitlist candidates by sex
Figure KI 22. Deceased donor kidney transplant rates among adult waitlist candidates by metropolitan vs. non-metropolitan residence
Figure KI 23. Three-year outcomes for adults waiting for kidney transplant, new listings in 2016
Figure KI 24. Percentage of adults who underwent deceased donor kidney transplant within a given time period of listing
Figure KI 25. Percentage of adults who underwent deceased donor kidney transplant within 5 years of listing, 2014, by DSA
Figure KI 26. Percentage of adults who underwent deceased donor kidney transplant within 5 years of listing, 2014, by state
Figure KI 27. Overall pretransplant mortality rates among adults waitlisted for kidney transplant
Figure KI 28. Pretransplant mortality rates among adults waitlisted for kidney transplant by age
Figure KI 29. Pretransplant mortality rates among adults waitlisted for kidney transplant by race
Figure KI 30. Pretransplant mortality rates among adults waitlisted for kidney transplant by sex
Figure KI 31. Pretransplant mortality rates among adults waitlisted for kidney transplant by diagnosis
Figure KI 32. Pretransplant mortality rates among adults waitlisted for kidney transplant by blood type
Figure KI 33. Pretransplant mortality rates among adults waitlisted for kidney transplant by metropolitan vs. non-metropolitan residence
Figure KI 34. Pretransplant mortality rates among adults waitlisted for kidney transplant, by active/inactive status
Figure KI 35. Pretransplant mortality rates among adults waitlisted for kidney transplant in 2019 by DSA
Figure KI 36. Deaths within six months after removal among adult kidney waitlist candidates, overall
Figure KI 37. Deaths within six months after removal among adult kidney waitlist candidates, by diagnosis group at removal
Figure KI 38. Deaths within six months after removal among adult kidney waitlist candidates, by age

Deceased donation

Figure KI 39. Overall deceased kidney donor count
Figure KI 40. Deceased kidney donor count by age
Figure KI 41. Deceased kidney donor count by HCV status
Figure KI 42. Distribution of deceased kidney donors by age
Figure KI 43. Distribution of deceased kidney donors by sex
Figure KI 44. Distribution of deceased kidney donors by race
Figure KI 45. Distribution of deceased kidney donors by donor HCV status
Figure KI 46. Percent of pediatric donor kidneys allocated to adult recipients, by DSA of donor hospital, 2015-2019
Figure KI 47. Overall rates of kidneys recovered for transplant and not transplanted
Figure KI 48. Rates of kidneys recovered for transplant and not transplanted by donor age
Figure KI 49. Rates of kidneys recovered for transplant and not transplanted by donor diabetes status
Figure KI 50. Rates of kidneys recovered for transplant and not transplanted by donor sex
Figure KI 51. Rates of kidneys recovered for transplant and not transplanted by donor race
Figure KI 52. Rates of kidneys recovered for transplant and not transplanted by donor hypertension status
Figure KI 53. Rates of kidneys recovered for transplant and not transplanted by donor BMI
Figure KI 54. Rates of kidneys recovered for transplant and not transplanted by donor terminal creatinine
Figure KI 55. Rates of kidneys recovered for transplant and not transplanted by donor biopsy status
Figure KI 56. Rates of kidneys recovered for transplant and not transplanted by donor cause of death
Figure KI 57. Rates of kidneys recovered for transplant and not transplanted by donor HCV status
Figure KI 58. Rates of kidneys recovered for transplant and not transplanted, by donor risk of disease transmission
Figure KI 59. Rates of kidneys recovered for transplant and not transplanted by DCD status
Figure KI 60. Rates of kidneys recovered for transplant and not transplanted by KDPI
Figure KI 61. Donor-specific components of the kidney donor risk index
Figure KI 62. Average kidney donor risk index
Figure KI 63. Average kidney donor risk index by biopsy status
Figure KI 64. Cause of death among deceased kidney donors

Living donation

Figure KI 65. Number of living kidney transplants by donor relation
Figure KI 66. Living kidney donors by age
Figure KI 67. Living kidney donors by sex
Figure KI 68. Living kidney donors by race
Figure KI 69. Intended living kidney donor procedure type
Figure KI 70. Rehospitalization among living kidney donors, 2014-2018
Figure KI 71. Kidney complications among living kidney donors, 2014-2018
Figure KI 72. BMI among living kidney donors

Transplant

Figure KI 73. Overall kidney transplants
Figure KI 74. Total kidney transplants by donor type
Figure KI 75. Total kidney transplants by age
Figure KI 76. Total kidney transplants by sex
Figure KI 77. Total kidney transplants by race
Figure KI 78. Total kidney transplants by diagnosis
Figure KI 79. Kidney transplants by kidney donor profile index (KDPI)
Figure KI 80. Total kidney-liver transplants by adult vs. pediatric age groups
Figure KI 81. Induction agent use in adult kidney transplant recipients
Figure KI 82. Immunosuppression regimen use in adult kidney transplant recipients
Figure KI 83. Peak C/PRA at time of kidney transplant in adult deceased donor recipients
Figure KI 84. Peak C/PRA at time of kidney transplant in adult living donor recipients
Figure KI 85. Total HLA A, B, and DR mismatches among adult kidney transplant recipients, 2015-2019
Figure KI 86. Annual adult kidney transplant center volumes by percentile
Figure KI 87. Distribution of adult kidney transplants by annual center volume

Outcomes

Figure KI 88. Graft failure among adult deceased donor kidney transplant recipients
Figure KI 89. Death-censored graft failure among adult deceased donor kidney transplant recipients
Figure KI 90. Death with function among adult deceased donor kidney transplant recipients
Figure KI 91. Graft failure among adult living donor kidney transplant recipients
Figure KI 92. Death-censored graft failure among adult living donor kidney transplant recipients
Figure KI 93. Death with function among adult living donor kidney transplant recipients
Figure KI 94. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by age
Figure KI 95. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by diagnosis
Figure KI 96. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by KDPI
Figure KI 97. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by DCD status
Figure KI 98. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by biopsy status
Figure KI 99. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by BMI
Figure KI 100. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by metropolitan vs. non-metropolitan recipient residence
Figure KI 101. Graft survival among adult living donor kidney transplant recipients, 2012-2014, by age
Figure KI 102. Graft survival among adult living donor kidney transplant recipients, 2012-2014, by race
Figure KI 103. Graft survival among adult living donor kidney transplant recipients, 2012-2014, by diagnosis
Figure KI 104. Graft survival among adult living donor kidney transplant recipients, 2012-2014, by metropolitan vs. non-metropolitan recipient residence
Figure KI 105. Distribution of eGFR at 12 months posttransplant among adult deceased donor kidney transplant recipients
Figure KI 106. Distribution of eGFR at 12 months posttransplant among adult living donor kidney transplant recipients
Figure KI 107. Recipients alive with a functioning kidney graft on June 30 of the year, by age at transplant
Figure KI 108. Incidence of acute rejection by 1 year posttransplant among adult kidney transplant recipients by age, 2017-2018
Figure KI 109. Incidence of acute rejection by 1 year posttransplant among adult kidney transplant recipients by induction agent, 2017-2018
Figure KI 110. Posttransplant diabetes among adult kidney transplant recipients
Figure KI 111. Posttransplant diabetes within 1 year among adult kidney transplant recipients by BMI at transplant
Figure KI 112. Incidence of PTLD among adult kidney transplant recipients by recipient EBV status at transplant, 2013-2017
Figure KI 113. Patient survival among adult deceased donor kidney transplant recipients, 2012-2014, by age
Figure KI 114. Patient survival among adult deceased donor kidney transplant recipients, 2012-2014, by diagnosis
Figure KI 115. Patient survival among adult deceased donor kidney transplant recipients, 2012-2014, by metropolitan vs. non-metropolitan recipient residence
Figure KI 116. Patient survival among adult deceased donor kidney transplant recipients, 2012-2014, by KDPI
Figure KI 117. Patient survival among adult deceased donor kidney transplant recipients, 2012-2014, by biopsy status
Figure KI 118. Patient survival among adult living donor kidney transplant recipients, 2012-2014, by age
Figure KI 119. Patient survival among adult living donor kidney transplant recipients, 2012-2014, by diagnosis
Figure KI 120. Patient survival among adult living donor kidney transplant recipients, 2012-2014, by race
Figure KI 121. Patient survival among adult living donor kidney transplant recipients, 2012-2014, by metropolitan vs. non-metropolitan recipient residence

Pediatric transplant

Figure KI 122. New pediatric candidates added to the kidney transplant waiting list
Figure KI 123. All pediatric candidates on the kidney transplant waiting list
Figure KI 124. Distribution of pediatric candidates waiting for kidney transplant by age
Figure KI 125. Distribution of pediatric candidates waiting for kidney transplant by race
Figure KI 126. Distribution of pediatric candidates waiting for kidney transplant by diagnosis
Figure KI 127. Distribution of pediatric candidates waiting for kidney transplant by sex
Figure KI 128. Distribution of pediatric candidates waiting for kidney transplant by waiting time
Figure KI 129. Distribution of pediatric candidates waiting for kidney transplant by C/PRA
Figure KI 130. Three-year outcomes for newly listed pediatric candidates waiting for kidney transplant, 2016
Figure KI 131. Overall deceased donor kidney transplant rates among pediatric waitlist candidates
Figure KI 132. Deceased donor kidney transplant rates among pediatric waitlist candidates by age
Figure KI 133. Deceased donor kidney transplant rates among pediatric waitlist candidates by race
Figure KI 134. Deceased donor kidney transplant rates among pediatric waitlist candidates by C/PRA
Figure KI 135. Deceased donor kidney transplant rates among pediatric waitlist candidates by metropolitan vs. non-metropolitan residence
Figure KI 136. Overall pretransplant mortality rates among pediatric candidates waitlisted for kidney
Figure KI 137. Pretransplant mortality rates among pediatric candidates waitlisted for kidney transplant by age
Figure KI 138. Pretransplant mortality rates among pediatric candidates waitlisted for kidney transplant by race
Figure KI 139. Pretransplant mortality rates among pediatric candidates waitlisted for kidney transplant by metropolitan vs. non-metropolitan residence
Figure KI 140. Overall pediatric kidney transplants
Figure KI 141. Pediatric kidney transplants by donor type
Figure KI 142. Pediatric kidney transplants by recipient age
Figure KI 143. Pediatric kidney transplants from living donors by relation
Figure KI 144. Percent of pediatric kidney transplants from living donors by recipient age
Figure KI 145. Number of centers performing pediatric and adult kidney transplants by center's age mix
Figure KI 146. Pediatric kidney recipients at programs that perform 5 or fewer pediatric transplants annually
Figure KI 147. Induction agent use in pediatric kidney transplant recipients
Figure KI 148. Immunosuppression regimen use in pediatric kidney transplant recipients
Figure KI 149. Total HLA A, B, and DR mismatches among pediatric kidney transplant recipients, 2015-2019
Figure KI 150. Distribution of eGFR at 12 months posttransplant among pediatric deceased donor kidney-alone transplant recipients
Figure KI 151. Distribution of eGFR at 12 months posttransplant among pediatric living donor kidney-alone transplant recipients
Figure KI 152. Graft failure among pediatric deceased donor kidney-alone transplant recipients
Figure KI 153. Death-censored graft failure among pediatric deceased donor kidney-alone transplant recipients
Figure KI 154. Death with function among pediatric deceased donor kidney-alone transplant recipients
Figure KI 155. Graft failure among pediatric living donor kidney-alone transplant recipients
Figure KI 156. Death-censored graft failure among pediatric living donor kidney-alone transplant recipients
Figure KI 157. Death with function among pediatric living donor kidney-alone transplant recipients
Figure KI 158. Graft failure among pediatric deceased donor kidney transplant recipients
Figure KI 159. Graft failure among pediatric living donor kidney transplant recipients
Figure KI 160. Graft survival among pediatric deceased donor kidney transplant recipients, 2012-2014, by age
Figure KI 161. Graft survival among pediatric kidney transplant recipients, 2012-2014, by donor type
Figure KI 162. Incidence of acute rejection by 1 year posttransplant among pediatric kidney transplant recipients by age, 2017-2018
Figure KI 163. Incidence of PTLD among pediatric kidney transplant recipients by recipient EBV status at transplant, 2007-2017
Figure KI 164. Patient death among pediatric kidney transplant recipients
Figure KI 165. Overall patient survival among pediatric deceased donor kidney transplant recipients, 2012-2014
Figure KI 166. Patient survival among pediatric deceased donor kidney transplant recipients, 2012-2014, by recipient age

Table List

Waiting list

Table KI 1. Demographic characteristics of adults on the kidney transplant waiting list on December 31, 2009, December 31, 2014 and December 31, 2019
Table KI 2. Clinical characteristics of adults on the kidney transplant waiting list on December 31, 2009, December 31, 2014 and December 31, 2019
Table KI 3. Listing characteristics of adults on the kidney transplant waiting list on December 31, 2009, December 31, 2014 and December 31, 2019
Table KI 4. Reasons for inactive status among new adult kidney transplant listings, 2019
Table KI 5. Kidney transplant waitlist activity among adults
Table KI 6. Removal reason among adult kidney transplant candidates

Living donation

Table KI 7. Living kidney donor deaths in the first year after donoation, 2015-2019, by number of days after donation

Transplant

Table KI 8. Demographic characteristics of adult kidney transplant recipients, 2019
Table KI 9. Clinical characteristics of adult kidney transplant recipients, 2019
Table KI 10. Transplant characteristics of adult kidney transplant recipients, 2019
Table KI 11. Adult deceased donor kidney donor-recipient serology matching, 2017-2019
Table KI 12. Adult living donor kidney donor-recipient serology matching, 2017-2019

Pediatric transplant

Table KI 13. Reasons for inactive status among new pediatric kidney transplant listings, 2019
Table KI 14. Demographic characteristics of pediatric candidates on the kidney transplant waiting list on December 31, 2009, December 31, 2014, and December 31, 2019
Table KI 15. Clinical characteristics of pediatric candidates on the kidney transplant waiting list on December 31, 2009, December 31, 2014, and December 31, 2019
Table KI 16. Listing characteristics of pediatric candidates on the kidney transplant waiting list on December 31, 2009, December 31, 2014, and December 31, 2019
Table KI 17. Kidney transplant waitlist activity among pediatric candidates
Table KI 18. Removal reason among pediatric kidney transplant candidates
Table KI 19. Demographic characteristics of pediatric kidney transplant recipients, 2017-2019
Table KI 20. Clinicial characteristics of pediatric kidney transplant recipients, 2017-2019
Table KI 21. Transplant characteristics of pediatric kidney transplant recipients, 2017-2019
Table KI 22. Pediatric deceased donor kidney donor-recipient serology matching, 2017-2019
Table KI 23. Pediatric living donor kidney donor-recipient serology matching, 2017-2019

A new candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and subsequently relisted are considered new. Active and inactive patients are included. Candidates listed at more than one center are counted once per listing. Includes kidney and kidney-pancreas listings.

Figure KI 1. New adult candidates added to the kidney transplant waiting list
A new candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and subsequently relisted are considered new. Active and inactive patients are included. Candidates listed at more than one center are counted once per listing. Includes kidney and kidney-pancreas listings.


Adult candidates on the list at any time during the year. Candidates listed at more than one center are counted once per listing. Includes kidney and kidney-pancreas candidates.

Figure KI 2. All adult candidates on the kidney transplant waiting list
Adult candidates on the list at any time during the year. Candidates listed at more than one center are counted once per listing. Includes kidney and kidney-pancreas candidates.


Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Age is determined at the later of listing date or January 1 of the given year. Active and inactive candidates are included.

Figure KI 3. Distribution of adults waiting for kidney transplant by age
Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Age is determined at the later of listing date or January 1 of the given year. Active and inactive candidates are included.


Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure KI 4. Distribution of adults waiting for kidney transplant by sex
Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.


Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure KI 5. Distribution of adults waiting for kidney transplant by race
Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.


Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure KI 6. Distribution of adults waiting for kidney transplant by diagnosis
Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.


Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Time on the waiting list is determined at the later of listing date or January 1 of the given year. Active and inactive candidates are included.

Figure KI 7. Distribution of adults waiting for kidney transplant by waiting time (years)
Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Time on the waiting list is determined at the later of listing date or January 1 of the given year. Active and inactive candidates are included.


Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure KI 8. Distribution of adults waiting for kidney transplant by BMI
Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.


Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Time on dialysis is computed as time from minimum of first ESRD service date or most recent graft failure to listing date or January 1 of the given year. Active and inactive candidates are included.

Figure KI 9. Distribution of adults waiting for kidney transplant by years on dialysis
Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Time on dialysis is computed as time from minimum of first ESRD service date or most recent graft failure to listing date or January 1 of the given year. Active and inactive candidates are included.


Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure KI 10. Distribution of adults waiting for kidney transplant by blood type
Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.


Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure KI 11. Distribution of adults waiting for kidney transplant by prior transplant status
Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.


Adults waiting for kidney transplant on December 31 of the given year. Candidates listed at more than one center are counted once per listing. Willingness to accept ECD at time of listing or willingness to accept a local non-zero HLA mismatch KDPI >85% kidney on December 31 of the given year, beginning in 2014. ECD, expanded criteria donor.

Figure KI 12. Adults willing to accept a kidney designated ECD or KDPI > 85% by age
Adults waiting for kidney transplant on December 31 of the given year. Candidates listed at more than one center are counted once per listing. Willingness to accept ECD at time of listing or willingness to accept a local non-zero HLA mismatch KDPI >85% kidney on December 31 of the given year, beginning in 2014. ECD, expanded criteria donor.


Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Willingness to accept HCV+ organ at time of listing. HCV, hepatitus C virus.

Figure KI 13. Adults willing to accept kidney from HCV+ donor
Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Willingness to accept HCV+ organ at time of listing. HCV, hepatitus C virus.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately.

Figure KI 14. Overall deceased donor kidney transplant rates among adult waitlist candidates
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year.

Figure KI 15. Deceased donor kidney transplant rates among adult waitlist candidates by age
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately.

Figure KI 16. Deceased donor kidney transplant rates among adult waitlist candidates by race
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately.

Figure KI 17. Deceased donor kidney transplant rates among adult waitlist candidates by diagnosis
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately. Peak c/PRA is used. c/PRA was used for 2010 and later. c/PRA was not consistently calculated for transplant recipients in 2008 and 2009 and is set to missing for those years.

Figure KI 18. Deceased donor kidney transplant rates among adult waitlist candidates by C/PRA
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately. Peak c/PRA is used. c/PRA was used for 2010 and later. c/PRA was not consistently calculated for transplant recipients in 2008 and 2009 and is set to missing for those years.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately.

Figure KI 19. Deceased donor kidney transplant rates among adult waitlist candidates by blood type
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately.

Figure KI 20. Deceased donor kidney transplant rates among adult waitlist candidates by time on the waitlist
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately.

Figure KI 21. Deceased donor kidney transplant rates among adult waitlist candidates by sex
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately. Urban/rural determination is made using the RUCA (Rural-Urban Commuting Area) designation of the candidate

Figure KI 22. Deceased donor kidney transplant rates among adult waitlist candidates by metropolitan vs. non-metropolitan residence
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of wait time in a given year. Individual listings are counted separately. Urban/rural determination is made using the RUCA (Rural-Urban Commuting Area) designation of the candidate's permanent zip code.


Candidates listed at more than one center are counted once per listing. Removed from list includes all reasons except transplant and death. DD, deceased donor; LD, living donor.

Figure KI 23. Three-year outcomes for adults waiting for kidney transplant, new listings in 2016
Candidates listed at more than one center are counted once per listing. Removed from list includes all reasons except transplant and death. DD, deceased donor; LD, living donor.


Candidates listed at more than one center are counted once per listing.

Figure KI 24. Percentage of adults who underwent deceased donor kidney transplant within a given time period of listing
Candidates listed at more than one center are counted once per listing.


Candidates listed at more than one center are counted once per listing.

Figure KI 25. Percentage of adults who underwent deceased donor kidney transplant within 5 years of listing, 2014, by DSA
Candidates listed at more than one center are counted once per listing.


Candidates listed at more than one center are counted once per listing. State is candidate

Figure KI 26. Percentage of adults who underwent deceased donor kidney transplant within 5 years of listing, 2014, by state
Candidates listed at more than one center are counted once per listing. State is candidate's home state.


Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

Figure KI 27. Overall pretransplant mortality rates among adults waitlisted for kidney transplant
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.


Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year.

Figure KI 28. Pretransplant mortality rates among adults waitlisted for kidney transplant by age
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year.


Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

Figure KI 29. Pretransplant mortality rates among adults waitlisted for kidney transplant by race
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.


Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

Figure KI 30. Pretransplant mortality rates among adults waitlisted for kidney transplant by sex
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.


Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. CKD, cystic kidney disease; DM, diabetes. HTN, hypertension. GN, glomerulonephritis.

Figure KI 31. Pretransplant mortality rates among adults waitlisted for kidney transplant by diagnosis
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. CKD, cystic kidney disease; DM, diabetes. HTN, hypertension. GN, glomerulonephritis.


Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

Figure KI 32. Pretransplant mortality rates among adults waitlisted for kidney transplant by blood type
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.


Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Urban/rural determination is made using the RUCA (Rural-Urban Commuting Area) designation of the candidate

Figure KI 33. Pretransplant mortality rates among adults waitlisted for kidney transplant by metropolitan vs. non-metropolitan residence
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Urban/rural determination is made using the RUCA (Rural-Urban Commuting Area) designation of the candidate's permanent zip code.


Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Status (active/inactive) is assessed on the later of January 1 of the given year and listing date.

Figure KI 34. Pretransplant mortality rates among adults waitlisted for kidney transplant, by active/inactive status
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Status (active/inactive) is assessed on the later of January 1 of the given year and listing date.


Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

Figure KI 35. Pretransplant mortality rates among adults waitlisted for kidney transplant in 2019 by DSA
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.


Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list.

Figure KI 36. Deaths within six months after removal among adult kidney waitlist candidates, overall
Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list.


Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list.

Figure KI 37. Deaths within six months after removal among adult kidney waitlist candidates, by diagnosis group at removal
Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list.


Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list. Age is determined at the later of listing date or January 1 of the given year.

Figure KI 38. Deaths within six months after removal among adult kidney waitlist candidates, by age
Denominator includes only candidates removed from the waiting list for reasons other than transplant or death while on the list. Age is determined at the later of listing date or January 1 of the given year.


Count of deceased donors from whom at least one kidney was recovered for transplant.

Figure KI 39. Overall deceased kidney donor count
Count of deceased donors from whom at least one kidney was recovered for transplant.


Count of deceased donors from whom at least one kidney was recovered for transplant.

Figure KI 40. Deceased kidney donor count by age
Count of deceased donors from whom at least one kidney was recovered for transplant.


Count of deceased donors from whom at least one kidney was recovered for transplant. Donor HCV status was based on an antibody test.

Figure KI 41. Deceased kidney donor count by HCV status
Count of deceased donors from whom at least one kidney was recovered for transplant. Donor HCV status was based on an antibody test.


Count of deceased donors from whom at least one kidney was recovered for transplant.

Figure KI 42. Distribution of deceased kidney donors by age
Count of deceased donors from whom at least one kidney was recovered for transplant.


Count of deceased donors from whom at least one kidney was recovered for transplant.

Figure KI 43. Distribution of deceased kidney donors by sex
Count of deceased donors from whom at least one kidney was recovered for transplant.


Count of deceased donors from whom at least one kidney was recovered for transplant.

Figure KI 44. Distribution of deceased kidney donors by race
Count of deceased donors from whom at least one kidney was recovered for transplant.


Count of deceased donors from whom at least one kidney was recovered for transplant. Donor HCV status was based on an antibody test.

Figure KI 45. Distribution of deceased kidney donors by donor HCV status
Count of deceased donors from whom at least one kidney was recovered for transplant. Donor HCV status was based on an antibody test.


Numerator: pediatric donor kidneys donors allocated to adult recipients. Denominator: total pediatric donor kidneys. When kidneys are transplanted individually, we count them separately. When they are transplanted as a block, the are considered one kidney.

Figure KI 46. Percent of pediatric donor kidneys allocated to adult recipients, by DSA of donor hospital, 2015-2019
Numerator: pediatric donor kidneys donors allocated to adult recipients. Denominator: total pediatric donor kidneys. When kidneys are transplanted individually, we count them separately. When they are transplanted as a block, the are considered one kidney.



Percentages of kidneys not transplanted out of all kidneys recovered for transplant.

Figure KI 47. Overall rates of kidneys recovered for transplant and not transplanted
Percentages of kidneys not transplanted out of all kidneys recovered for transplant.



Percentages of kidneys not transplanted out of all kidneys recovered for transplant.

Figure KI 48. Rates of kidneys recovered for transplant and not transplanted by donor age
Percentages of kidneys not transplanted out of all kidneys recovered for transplant.



Percentages of kidneys not transplanted out of all kidneys recovered for transplant.

Figure KI 49. Rates of kidneys recovered for transplant and not transplanted by donor diabetes status
Percentages of kidneys not transplanted out of all kidneys recovered for transplant.



Percentages of kidneys not transplanted out of all kidneys recovered for transplant.

Figure KI 50. Rates of kidneys recovered for transplant and not transplanted by donor sex
Percentages of kidneys not transplanted out of all kidneys recovered for transplant.



Percentages of kidneys not transplanted out of all kidneys recovered for transplant.

Figure KI 51. Rates of kidneys recovered for transplant and not transplanted by donor race
Percentages of kidneys not transplanted out of all kidneys recovered for transplant.



Percentages of kidneys not transplanted out of all kidneys recovered for transplant.

Figure KI 52. Rates of kidneys recovered for transplant and not transplanted by donor hypertension status
Percentages of kidneys not transplanted out of all kidneys recovered for transplant.



Percentages of kidneys not transplanted out of all kidneys recovered for transplant.

Figure KI 53. Rates of kidneys recovered for transplant and not transplanted by donor BMI
Percentages of kidneys not transplanted out of all kidneys recovered for transplant.


Percentages of kidneys not transplanted out of all kidneys recovered for transplant.

Figure KI 54. Rates of kidneys recovered for transplant and not transplanted by donor terminal creatinine
Percentages of kidneys not transplanted out of all kidneys recovered for transplant.


Percentages of kidneys not transplanted out of all kidneys recovered for transplant.  Kidneys are classified as biopsied if either of the donor

Figure KI 55. Rates of kidneys recovered for transplant and not transplanted by donor biopsy status
Percentages of kidneys not transplanted out of all kidneys recovered for transplant. Kidneys are classified as biopsied if either of the donor's kidneys was biopsied.


Percentages of kidneys not transplanted out of all kidneys recovered for transplant. CVA, cerebrovascular accident.

Figure KI 56. Rates of kidneys recovered for transplant and not transplanted by donor cause of death
Percentages of kidneys not transplanted out of all kidneys recovered for transplant. CVA, cerebrovascular accident.


Percentages of kidneys not transplanted out of all kidneys recovered for transplant. Donor HCV status was based on an antibody test.

Figure KI 57. Rates of kidneys recovered for transplant and not transplanted by donor HCV status
Percentages of kidneys not transplanted out of all kidneys recovered for transplant. Donor HCV status was based on an antibody test.


Percentages of kidneys not transplanted out of all kidneys recovered for transplant.  "Increased risk" is defined by criteria from the US Public Health Service Guidelines for increased risk for HIV, hepatitis B and hepatitis C transmission.

Figure KI 58. Rates of kidneys recovered for transplant and not transplanted, by donor risk of disease transmission
Percentages of kidneys not transplanted out of all kidneys recovered for transplant. "Increased risk" is defined by criteria from the US Public Health Service Guidelines for increased risk for HIV, hepatitis B and hepatitis C transmission.


Percentages of kidneys not transplanted out of all kidneys recovered for transplant. DBD, donation after brain death; DCD, donation after circulatory death.

Figure KI 59. Rates of kidneys recovered for transplant and not transplanted by DCD status
Percentages of kidneys not transplanted out of all kidneys recovered for transplant. DBD, donation after brain death; DCD, donation after circulatory death.


Percentages of kidneys not transplanted out of all kidneys recovered for transplant, by KDPI classification. The reference population for the KDRI to KDPI conversion is all deceased donor kidneys recovered for transplant in the US in 2019. KDPI, kidney donor profile index; KDRI, kidney donor risk index.

Figure KI 60. Rates of kidneys recovered for transplant and not transplanted by KDPI
Percentages of kidneys not transplanted out of all kidneys recovered for transplant, by KDPI classification. The reference population for the KDRI to KDPI conversion is all deceased donor kidneys recovered for transplant in the US in 2019. KDPI, kidney donor profile index; KDRI, kidney donor risk index.


Donors with at least one transplanted kidney. The donor-specific components of the kidney donor risk index are shown, except for donor height. CVA, cerebrovascular accident; DCD, donation after circulatory death; SCr, serum creatinine.

Figure KI 61. Donor-specific components of the kidney donor risk index
Donors with at least one transplanted kidney. The donor-specific components of the kidney donor risk index are shown, except for donor height. CVA, cerebrovascular accident; DCD, donation after circulatory death; SCr, serum creatinine.


Kidneys recovered for transplant. Kidney donor risk index is computed using only donor-specific components, and is not converted to KDPI.

Figure KI 62. Average kidney donor risk index
Kidneys recovered for transplant. Kidney donor risk index is computed using only donor-specific components, and is not converted to KDPI.


Kidneys recovered for transplant. Kidney donor risk index is computed using only donor-specific components, and is not converted to KDPI.  Kidneys are classified as biopsied if either of the donor

Figure KI 63. Average kidney donor risk index by biopsy status
Kidneys recovered for transplant. Kidney donor risk index is computed using only donor-specific components, and is not converted to KDPI. Kidneys are classified as biopsied if either of the donor's kidneys was biopsied.


Deceased donors from whom at least on kidney was transplanted. Each donor is counted once. CVA, cerebrovascular accident.

Figure KI 64. Cause of death among deceased kidney donors
Deceased donors from whom at least on kidney was transplanted. Each donor is counted once. CVA, cerebrovascular accident.


As reported on the OPTN Living Donor Registration Form.

Figure KI 65. Number of living kidney transplants by donor relation
As reported on the OPTN Living Donor Registration Form.


As reported on the OPTN Living Donor Registration Form.

Figure KI 66. Living kidney donors by age
As reported on the OPTN Living Donor Registration Form.


As reported on the OPTN Living Donor Registration Form.

Figure KI 67. Living kidney donors by sex
As reported on the OPTN Living Donor Registration Form.


As reported on the OPTN Living Donor Registration Form.

Figure KI 68. Living kidney donors by race
As reported on the OPTN Living Donor Registration Form.


As reported on the OPTN Living Donor Registration Form.

Figure KI 69. Intended living kidney donor procedure type
As reported on the OPTN Living Donor Registration Form.


Cumulative hospital readmission. The discharge time point is recorded at the earliest of discharge or 6 weeks after donation.

Figure KI 70. Rehospitalization among living kidney donors, 2014-2018
Cumulative hospital readmission. The discharge time point is recorded at the earliest of discharge or 6 weeks after donation.


Complications reported on the OPTN Living Donor Registration and Living Donor Follow-up Forms at each time point. Complications include readmission, re-operation, vascular complications, and other complications requiring intervention. Multiple complications may be reported at any time point.

Figure KI 71. Kidney complications among living kidney donors, 2014-2018
Complications reported on the OPTN Living Donor Registration and Living Donor Follow-up Forms at each time point. Complications include readmission, re-operation, vascular complications, and other complications requiring intervention. Multiple complications may be reported at any time point.


Donor height and weight reported on the OPTN Living Donor Registration Form.

Figure KI 72. BMI among living kidney donors
Donor height and weight reported on the OPTN Living Donor Registration Form.


All kidney transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.

Figure KI 73. Overall kidney transplants
All kidney transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


All kidney transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.

Figure KI 74. Total kidney transplants by donor type
All kidney transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


All kidney transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.

Figure KI 75. Total kidney transplants by age
All kidney transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


All kidney transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.

Figure KI 76. Total kidney transplants by sex
All kidney transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


All kidney transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.

Figure KI 77. Total kidney transplants by race
All kidney transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients.


All kidney transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients. GN, glomerulonephritis; CKD, cystic kidney disease.

Figure KI 78. Total kidney transplants by diagnosis
All kidney transplant recipients, including adult and pediatric, retransplant, and multi-organ recipients. GN, glomerulonephritis; CKD, cystic kidney disease.


All adult recipients of deceased donor kidneys, including multi-organ transplants. The reference population for the KDRI to KDPI conversion is all deceased donor kidneys recovered for transplant in the US in 2019. Kidneys recovered en-bloc are counted once. KDPI, kidney donor profile index; KDRI, kidney donor risk index.

Figure KI 79. Kidney transplants by kidney donor profile index (KDPI)
All adult recipients of deceased donor kidneys, including multi-organ transplants. The reference population for the KDRI to KDPI conversion is all deceased donor kidneys recovered for transplant in the US in 2019. Kidneys recovered en-bloc are counted once. KDPI, kidney donor profile index; KDRI, kidney donor risk index.


All kidney-liver transplant recipients, including procedures with more than two organs.

Figure KI 80. Total kidney-liver transplants by adult vs. pediatric age groups
All kidney-liver transplant recipients, including procedures with more than two organs.


Immunosuppression at transplant reported to the OPTN.

Figure KI 81. Induction agent use in adult kidney transplant recipients
Immunosuppression at transplant reported to the OPTN.


Immunosuppression regimen at transplant reported to the OPTN. Tac, tacrolimus. MMF, all mycophenolate agents.

Figure KI 82. Immunosuppression regimen use in adult kidney transplant recipients
Immunosuppression regimen at transplant reported to the OPTN. Tac, tacrolimus. MMF, all mycophenolate agents.


Peak c/PRA is used. c/PRA was used for 2010 and later. c/PRA was not consistently calculated for transplant recipients in 2008 and 2009 and is set to missing for those years. Kidney-alone transplants only.

Figure KI 83. Peak C/PRA at time of kidney transplant in adult deceased donor recipients
Peak c/PRA is used. c/PRA was used for 2010 and later. c/PRA was not consistently calculated for transplant recipients in 2008 and 2009 and is set to missing for those years. Kidney-alone transplants only.


Peak c/PRA is used. c/PRA was used for 2010 and later. c/PRA was not consistently calculated for transplant recipients in 2008 and 2009 and is set to missing for those years. Kidney-alone transplants only.

Figure KI 84. Peak C/PRA at time of kidney transplant in adult living donor recipients
Peak c/PRA is used. c/PRA was used for 2010 and later. c/PRA was not consistently calculated for transplant recipients in 2008 and 2009 and is set to missing for those years. Kidney-alone transplants only.


Donor and recipient antigen matching is based on OPTN antigen values and split equivalences policy as of 2018.

Figure KI 85. Total HLA A, B, and DR mismatches among adult kidney transplant recipients, 2015-2019
Donor and recipient antigen matching is based on OPTN antigen values and split equivalences policy as of 2018.


Annual volume data are limited to recipients aged 18 years or older.

Figure KI 86. Annual adult kidney transplant center volumes by percentile
Annual volume data are limited to recipients aged 18 years or older.


Based on annual volume data among recipients aged 18 or older.

Figure KI 87. Distribution of adult kidney transplants by annual center volume
Based on annual volume data among recipients aged 18 or older.


Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. All-cause graft failure (GF) is defined as any of the prior outcomes prior to 6 months, 1, 3, 5, or 10 years, respectively.

Figure KI 88. Graft failure among adult deceased donor kidney transplant recipients
Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. All-cause graft failure (GF) is defined as any of the prior outcomes prior to 6 months, 1, 3, 5, or 10 years, respectively.


Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death-censored graft failure (DCGF) is defined as a return to dialysis, reported graft failure, or kidney retransplant.

Figure KI 89. Death-censored graft failure among adult deceased donor kidney transplant recipients
Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death-censored graft failure (DCGF) is defined as a return to dialysis, reported graft failure, or kidney retransplant.


Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death with function (DWF) is defined as death without prior graft failure, return to dialysis, or retransplant.

Figure KI 90. Death with function among adult deceased donor kidney transplant recipients
Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death with function (DWF) is defined as death without prior graft failure, return to dialysis, or retransplant.


Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. All-cause graft failure (GF) is defined as any of the prior outcomes prior to 6 months, 1, 3, 5, or 10 years, respectively.

Figure KI 91. Graft failure among adult living donor kidney transplant recipients
Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. All-cause graft failure (GF) is defined as any of the prior outcomes prior to 6 months, 1, 3, 5, or 10 years, respectively.


Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death-censored graft failure (DCGF) is defined as a return to dialysis, reported graft failure, or kidney retransplant.

Figure KI 92. Death-censored graft failure among adult living donor kidney transplant recipients
Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death-censored graft failure (DCGF) is defined as a return to dialysis, reported graft failure, or kidney retransplant.


Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death with function (DWF) is defined as death without prior graft failure, return to dialysis, or retransplant.

Figure KI 93. Death with function among adult living donor kidney transplant recipients
Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death with function (DWF) is defined as death without prior graft failure, return to dialysis, or retransplant.


Graft survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 94. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by age
Graft survival estimated using unadjusted Kaplan-Meier methods.


Graft survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 95. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by diagnosis
Graft survival estimated using unadjusted Kaplan-Meier methods.


Graft survival estimated using unadjusted Kaplan-Meier methods. The reference population for the KDRI to KDPI conversion is all deceased donor kidneys recovered for transplant in the US in 2019. KDPI, kidney donor profile index.

Figure KI 96. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by KDPI
Graft survival estimated using unadjusted Kaplan-Meier methods. The reference population for the KDRI to KDPI conversion is all deceased donor kidneys recovered for transplant in the US in 2019. KDPI, kidney donor profile index.


Graft survival estimated using unadjusted Kaplan-Meier methods. DCD, donation after circulatory death; DBD, donation after brain death.

Figure KI 97. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by DCD status
Graft survival estimated using unadjusted Kaplan-Meier methods. DCD, donation after circulatory death; DBD, donation after brain death.


Graft survival estimated using unadjusted Kaplan-Meier methods.  Kidneys are classified as biopsied if either of the donor

Figure KI 98. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by biopsy status
Graft survival estimated using unadjusted Kaplan-Meier methods. Kidneys are classified as biopsied if either of the donor's kidneys was biopsied.


Graft survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 99. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by BMI
Graft survival estimated using unadjusted Kaplan-Meier methods.


Graft survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 100. Graft survival among adult deceased donor kidney transplant recipients, 2012-2014, by metropolitan vs. non-metropolitan recipient residence
Graft survival estimated using unadjusted Kaplan-Meier methods.


Graft survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 101. Graft survival among adult living donor kidney transplant recipients, 2012-2014, by age
Graft survival estimated using unadjusted Kaplan-Meier methods.


Graft survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 102. Graft survival among adult living donor kidney transplant recipients, 2012-2014, by race
Graft survival estimated using unadjusted Kaplan-Meier methods.


Graft survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 103. Graft survival among adult living donor kidney transplant recipients, 2012-2014, by diagnosis
Graft survival estimated using unadjusted Kaplan-Meier methods.


Graft survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 104. Graft survival among adult living donor kidney transplant recipients, 2012-2014, by metropolitan vs. non-metropolitan recipient residence
Graft survival estimated using unadjusted Kaplan-Meier methods.


GFR (mL/min/1.73 m<sup>2</sup>) estimated using the Chronic Kidney Disease Epidemiology Collaboration equation, and computed for patients alive with graft function at 6 months posttransplant.

Figure KI 105. Distribution of eGFR at 12 months posttransplant among adult deceased donor kidney transplant recipients
GFR (mL/min/1.73 m2) estimated using the Chronic Kidney Disease Epidemiology Collaboration equation, and computed for patients alive with graft function at 6 months posttransplant.


GFR (mL/min/1.73 m<sup>2</sup>) estimated using the Chronic Kidney Disease Epidemiology Collaboration equation, and computed for patients alive with graft function at 6 months posttransplant.

Figure KI 106. Distribution of eGFR at 12 months posttransplant among adult living donor kidney transplant recipients
GFR (mL/min/1.73 m2) estimated using the Chronic Kidney Disease Epidemiology Collaboration equation, and computed for patients alive with graft function at 6 months posttransplant.


Recipients are assumed to be alive with function unless a death or graft failure is recorded. A recipient may experience a graft failure and be removed from the cohort, undergo retransplant, and re-enter the cohort.

Figure KI 107. Recipients alive with a functioning kidney graft on June 30 of the year, by age at transplant
Recipients are assumed to be alive with function unless a death or graft failure is recorded. A recipient may experience a graft failure and be removed from the cohort, undergo retransplant, and re-enter the cohort.


Only the first reported rejection event is counted. Cumulative incidence is estimated using the Kaplan-Meier method.

Figure KI 108. Incidence of acute rejection by 1 year posttransplant among adult kidney transplant recipients by age, 2017-2018
Only the first reported rejection event is counted. Cumulative incidence is estimated using the Kaplan-Meier method.


Only the first reported rejection event is counted. Cumulative incidence is estimated using the Kaplan-Meier method. IL2-RA, interleukin-2 receptor agonist; TCD, T-cell depleting.

Figure KI 109. Incidence of acute rejection by 1 year posttransplant among adult kidney transplant recipients by induction agent, 2017-2018
Only the first reported rejection event is counted. Cumulative incidence is estimated using the Kaplan-Meier method. IL2-RA, interleukin-2 receptor agonist; TCD, T-cell depleting.


Percentage of adult deceased donor kidney recipients who were nondiabetic at transplant and developed diabetes posttransplant. Posttransplant diabetes is reported on the Transplant Recipient Follow-up Form. Death and graft failure are treated as competing events.

Figure KI 110. Posttransplant diabetes among adult kidney transplant recipients
Percentage of adult deceased donor kidney recipients who were nondiabetic at transplant and developed diabetes posttransplant. Posttransplant diabetes is reported on the Transplant Recipient Follow-up Form. Death and graft failure are treated as competing events.


Percentage of adult deceased donor kidney recipients who were nondiabetic at transplant and developed diabetes posttransplant. Posttransplant diabetes is reported on the Transplant Recipient Follow-up Form. Death and graft failure are treated as competing events.

Figure KI 111. Posttransplant diabetes within 1 year among adult kidney transplant recipients by BMI at transplant
Percentage of adult deceased donor kidney recipients who were nondiabetic at transplant and developed diabetes posttransplant. Posttransplant diabetes is reported on the Transplant Recipient Follow-up Form. Death and graft failure are treated as competing events.


Cumulative incidence is estimated using the Kaplan-Meier method. PTLD is identified as a reported complication or cause of death on the OPTN Transplant Recipient Follow-up Form or the Posttransplant Malignancy Form as polymorphic PTLD, monomorphic PTLD, or Hodgkin

Figure KI 112. Incidence of PTLD among adult kidney transplant recipients by recipient EBV status at transplant, 2013-2017
Cumulative incidence is estimated using the Kaplan-Meier method. PTLD is identified as a reported complication or cause of death on the OPTN Transplant Recipient Follow-up Form or the Posttransplant Malignancy Form as polymorphic PTLD, monomorphic PTLD, or Hodgkin's disease. Only the earliest date of PTLD diagnosis is considered. EBV, Epstein-Barr virus; PTLD, posttransplant lymphoproliferative disorder.


Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 113. Patient survival among adult deceased donor kidney transplant recipients, 2012-2014, by age
Patient survival estimated using unadjusted Kaplan-Meier methods.


Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 114. Patient survival among adult deceased donor kidney transplant recipients, 2012-2014, by diagnosis
Patient survival estimated using unadjusted Kaplan-Meier methods.


Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 115. Patient survival among adult deceased donor kidney transplant recipients, 2012-2014, by metropolitan vs. non-metropolitan recipient residence
Patient survival estimated using unadjusted Kaplan-Meier methods.


Patient survival estimated using unadjusted Kaplan-Meier methods. The reference population for the KDRI to KDPI conversion is all deceased donor kidneys recovered for transplant in the US in 2019. KDPI, kidney donor profile index.

Figure KI 116. Patient survival among adult deceased donor kidney transplant recipients, 2012-2014, by KDPI
Patient survival estimated using unadjusted Kaplan-Meier methods. The reference population for the KDRI to KDPI conversion is all deceased donor kidneys recovered for transplant in the US in 2019. KDPI, kidney donor profile index.


Patient survival estimated using unadjusted Kaplan-Meier methods.  Kidneys are classified as biopsied if either of the donor

Figure KI 117. Patient survival among adult deceased donor kidney transplant recipients, 2012-2014, by biopsy status
Patient survival estimated using unadjusted Kaplan-Meier methods. Kidneys are classified as biopsied if either of the donor's kidneys was biopsied.


Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 118. Patient survival among adult living donor kidney transplant recipients, 2012-2014, by age
Patient survival estimated using unadjusted Kaplan-Meier methods.


Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 119. Patient survival among adult living donor kidney transplant recipients, 2012-2014, by diagnosis
Patient survival estimated using unadjusted Kaplan-Meier methods.


Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 120. Patient survival among adult living donor kidney transplant recipients, 2012-2014, by race
Patient survival estimated using unadjusted Kaplan-Meier methods.


Patient survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 121. Patient survival among adult living donor kidney transplant recipients, 2012-2014, by metropolitan vs. non-metropolitan recipient residence
Patient survival estimated using unadjusted Kaplan-Meier methods.


A new candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and subsequently relisted are considered new. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure KI 122. New pediatric candidates added to the kidney transplant waiting list
A new candidate is one who first joined the list during the given year, without having been listed in a previous year. Previously listed candidates who underwent transplant and subsequently relisted are considered new. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.


Candidates listed at more than one center are counted once per listing; age determined at first listing.

Figure KI 123. All pediatric candidates on the kidney transplant waiting list
Candidates listed at more than one center are counted once per listing; age determined at first listing.


Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Age is determined at the later of listing date or January 1 of the given year. Active and inactive candidates are included.

Figure KI 124. Distribution of pediatric candidates waiting for kidney transplant by age
Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Age is determined at the later of listing date or January 1 of the given year. Active and inactive candidates are included.


Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included.

Figure KI 125. Distribution of pediatric candidates waiting for kidney transplant by race
Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive candidates are included.


Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Diagnosis categories follow North American Pediatric Renal Trials and Collaborative Studies recommendations. Active and inactive candidates are included. FSGS, focal segmental glomerulosclerosis; CAKUT, congenital anomalies of the kidney and urinary tract.

Figure KI 126. Distribution of pediatric candidates waiting for kidney transplant by diagnosis
Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Diagnosis categories follow North American Pediatric Renal Trials and Collaborative Studies recommendations. Active and inactive candidates are included. FSGS, focal segmental glomerulosclerosis; CAKUT, congenital anomalies of the kidney and urinary tract.


Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.

Figure KI 127. Distribution of pediatric candidates waiting for kidney transplant by sex
Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Active and inactive patients are included.


Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Time on the waiting list is determined at the later of listing date or January 1 of the given year. Active and inactive candidates are included.

Figure KI 128. Distribution of pediatric candidates waiting for kidney transplant by waiting time
Candidates waiting for transplant any time in the given year. Candidates listed at more than one center are counted once per listing. Time on the waiting list is determined at the later of listing date or January 1 of the given year. Active and inactive candidates are included.


Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Peak c/PRA is used. c/PRA was used for 2010 and later. c/PRA was not consistently calculated for transplant recipients in 2008 and 2009 and is set to missing for those years. Active and inactive candidates are included.

Figure KI 129. Distribution of pediatric candidates waiting for kidney transplant by C/PRA
Candidates waiting for transplant at any time in the given year. Candidates listed at more than one center are counted once per listing. Peak c/PRA is used. c/PRA was used for 2010 and later. c/PRA was not consistently calculated for transplant recipients in 2008 and 2009 and is set to missing for those years. Active and inactive candidates are included.


Pediatric candidates who joined the waitlist in 2016. Candidates listed at more than one center are counted once per listing. DD, deceased donor; LD, living donor.

Figure KI 130. Three-year outcomes for newly listed pediatric candidates waiting for kidney transplant, 2016
Pediatric candidates who joined the waitlist in 2016. Candidates listed at more than one center are counted once per listing. DD, deceased donor; LD, living donor.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting in a given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year. The age category 18 years or older includes candidates listed when pediatrics but still on the list in the given year.

Figure KI 131. Overall deceased donor kidney transplant rates among pediatric waitlist candidates
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting in a given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year. The age category 18 years or older includes candidates listed when pediatrics but still on the list in the given year.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting in a given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year. The age category 18 years or older includes candidates listed when pediatrics but still on the list in the given year.

Figure KI 132. Deceased donor kidney transplant rates among pediatric waitlist candidates by age
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting in a given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year. The age category 18 years or older includes candidates listed when pediatrics but still on the list in the given year.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting in a given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year.

Figure KI 133. Deceased donor kidney transplant rates among pediatric waitlist candidates by race
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting in a given year. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting in a given year. Individual listings are counted separately. Peak c/PRA is used. c/PRA was used for 2010 and later. c/PRA was not consistently calculated for transplant recipients in 2008 and 2009 and is set to missing for those years.

Figure KI 134. Deceased donor kidney transplant rates among pediatric waitlist candidates by C/PRA
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting in a given year. Individual listings are counted separately. Peak c/PRA is used. c/PRA was used for 2010 and later. c/PRA was not consistently calculated for transplant recipients in 2008 and 2009 and is set to missing for those years.


Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting in a given year. Individual listings are counted separately.

Figure KI 135. Deceased donor kidney transplant rates among pediatric waitlist candidates by metropolitan vs. non-metropolitan residence
Transplant rates are computed as the number of deceased donor transplants per 100 patient-years of waiting in a given year. Individual listings are counted separately.


Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Individual listings are counted separately.

Figure KI 136. Overall pretransplant mortality rates among pediatric candidates waitlisted for kidney
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Individual listings are counted separately.


Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year.

Figure KI 137. Pretransplant mortality rates among pediatric candidates waitlisted for kidney transplant by age
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Age is determined at the later of listing date or January 1 of the given year.


Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.

Figure KI 138. Pretransplant mortality rates among pediatric candidates waitlisted for kidney transplant by race
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.


Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately.  Urban/rural determination is made using the RUCA (Rural-Urban Commuting Area) designation of the candidate

Figure KI 139. Pretransplant mortality rates among pediatric candidates waitlisted for kidney transplant by metropolitan vs. non-metropolitan residence
Mortality rates are computed as the number of deaths per 100 patient-years of waiting in the given year. Waiting time is censored at transplant, death, transfer to another program, removal because of improved condition, or end of cohort. Individual listings are counted separately. Urban/rural determination is made using the RUCA (Rural-Urban Commuting Area) designation of the candidate's permanent zip code.


All pediatric kidney transplant recipients, including retransplant, and multi-organ recipients.

Figure KI 140. Overall pediatric kidney transplants
All pediatric kidney transplant recipients, including retransplant, and multi-organ recipients.


All pediatric kidney transplant recipients, including retransplant, and multi-organ recipients.

Figure KI 141. Pediatric kidney transplants by donor type
All pediatric kidney transplant recipients, including retransplant, and multi-organ recipients.


All pediatric kidney transplant recipients, including retransplant, and multi-organ recipients.

Figure KI 142. Pediatric kidney transplants by recipient age
All pediatric kidney transplant recipients, including retransplant, and multi-organ recipients.


Relationship of living donor to recipient is as indicated on the OPTN Living Donor Registration Form.

Figure KI 143. Pediatric kidney transplants from living donors by relation
Relationship of living donor to recipient is as indicated on the OPTN Living Donor Registration Form.


All pediatric living kidney transplant recipients, including retransplant, and multi-organ recipients.

Figure KI 144. Percent of pediatric kidney transplants from living donors by recipient age
All pediatric living kidney transplant recipients, including retransplant, and multi-organ recipients.


Adult centers transplanted only recipients aged 18 years or older. Functionally adult centers transplanted 80% adults or more, and the remainder were children aged 15-17 years. Mixed included adults and children of any age groups. Pediatric center transplanted recipients aged 0-17 years, and a small number of adults up to age 21 years.

Figure KI 145. Number of centers performing pediatric and adult kidney transplants by center's age mix
Adult centers transplanted only recipients aged 18 years or older. Functionally adult centers transplanted 80% adults or more, and the remainder were children aged 15-17 years. Mixed included adults and children of any age groups. Pediatric center transplanted recipients aged 0-17 years, and a small number of adults up to age 21 years.


Age groups are cumulative.

Figure KI 146. Pediatric kidney recipients at programs that perform 5 or fewer pediatric transplants annually
Age groups are cumulative.


Immunosuppression at transplant reported to the OPTN.

Figure KI 147. Induction agent use in pediatric kidney transplant recipients
Immunosuppression at transplant reported to the OPTN.


Immunosuppression regimen at transplant reported to the OPTN. Tac, tacrolimus. MMF, all mycophenolate agents.

Figure KI 148. Immunosuppression regimen use in pediatric kidney transplant recipients
Immunosuppression regimen at transplant reported to the OPTN. Tac, tacrolimus. MMF, all mycophenolate agents.


Donor and recipient antigen matching is based on OPTN antigen values and split equivalences policy as of 2016.

Figure KI 149. Total HLA A, B, and DR mismatches among pediatric kidney transplant recipients, 2015-2019
Donor and recipient antigen matching is based on OPTN antigen values and split equivalences policy as of 2016.


GFR (mL/min/1.73 m<sup>2</sup>) estimated using the bedside Schwartz equation, and computed for patients alive with graft function at 12 months posttransplant. Equation: eGFR = 0.413*Height(cm)/Creatinine (mg/dL).

Figure KI 150. Distribution of eGFR at 12 months posttransplant among pediatric deceased donor kidney-alone transplant recipients
GFR (mL/min/1.73 m2) estimated using the bedside Schwartz equation, and computed for patients alive with graft function at 12 months posttransplant. Equation: eGFR = 0.413*Height(cm)/Creatinine (mg/dL).


GFR (mL/min/1.73 m<sup>2</sup>) estimated using the bedside Schwartz equation, and computed for patients alive with graft function at 12 months posttransplant. Equation: eGFR = 0.413*Height(cm)/Creatinine (mg/dL).

Figure KI 151. Distribution of eGFR at 12 months posttransplant among pediatric living donor kidney-alone transplant recipients
GFR (mL/min/1.73 m2) estimated using the bedside Schwartz equation, and computed for patients alive with graft function at 12 months posttransplant. Equation: eGFR = 0.413*Height(cm)/Creatinine (mg/dL).


Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. All-cause graft failure (GF) is defined as any of the prior outcomes prior to 6 months, 1, 3, 5, or 10 years, respectively.

Figure KI 152. Graft failure among pediatric deceased donor kidney-alone transplant recipients
Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. All-cause graft failure (GF) is defined as any of the prior outcomes prior to 6 months, 1, 3, 5, or 10 years, respectively.


Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death-censored graft failure (DCGF) is defined as a return to dialysis, reported graft failure, or kidney retransplant.

Figure KI 153. Death-censored graft failure among pediatric deceased donor kidney-alone transplant recipients
Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death-censored graft failure (DCGF) is defined as a return to dialysis, reported graft failure, or kidney retransplant.


Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death with function (DWF) is defined as death without prior graft failure, return to dialysis, or retransplant.

Figure KI 154. Death with function among pediatric deceased donor kidney-alone transplant recipients
Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death with function (DWF) is defined as death without prior graft failure, return to dialysis, or retransplant.


Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. All-cause graft failure (GF) is defined as any of the prior outcomes prior to 6 months, 1, 3, 5, or 10 years, respectively.

Figure KI 155. Graft failure among pediatric living donor kidney-alone transplant recipients
Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. All-cause graft failure (GF) is defined as any of the prior outcomes prior to 6 months, 1, 3, 5, or 10 years, respectively.


Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death-censored graft failure (DCGF) is defined as a return to dialysis, reported graft failure, or kidney retransplant.

Figure KI 156. Death-censored graft failure among pediatric living donor kidney-alone transplant recipients
Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death-censored graft failure (DCGF) is defined as a return to dialysis, reported graft failure, or kidney retransplant.


Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death with function (DWF) is defined as death without prior graft failure, return to dialysis, or retransplant.

Figure KI 157. Death with function among pediatric living donor kidney-alone transplant recipients
Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. Death with function (DWF) is defined as death without prior graft failure, return to dialysis, or retransplant.


All pediatric recipients of deceased donor livers, including multi-organ transplants. Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. All-cause graft failure (GF) is defined as any of the prior outcomes prior to 6 months, 1, 3, 5, or 10 years, respectively.

Figure KI 158. Graft failure among pediatric deceased donor kidney transplant recipients
All pediatric recipients of deceased donor livers, including multi-organ transplants. Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. All-cause graft failure (GF) is defined as any of the prior outcomes prior to 6 months, 1, 3, 5, or 10 years, respectively.


All pediatric recipients of living donor livers, including multi-organ transplants. Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. All-cause graft failure (GF) is defined as any of the prior outcomes prior to 6 months, 1, 3, 5, or 10 years, respectively.

Figure KI 159. Graft failure among pediatric living donor kidney transplant recipients
All pediatric recipients of living donor livers, including multi-organ transplants. Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant. All-cause graft failure (GF) is defined as any of the prior outcomes prior to 6 months, 1, 3, 5, or 10 years, respectively.


Recipient survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 160. Graft survival among pediatric deceased donor kidney transplant recipients, 2012-2014, by age
Recipient survival estimated using unadjusted Kaplan-Meier methods.


Recipient survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 161. Graft survival among pediatric kidney transplant recipients, 2012-2014, by donor type
Recipient survival estimated using unadjusted Kaplan-Meier methods.


Only the first reported rejection event is counted. Cumulative incidence is estimated using the Kaplan-Meier method.

Figure KI 162. Incidence of acute rejection by 1 year posttransplant among pediatric kidney transplant recipients by age, 2017-2018
Only the first reported rejection event is counted. Cumulative incidence is estimated using the Kaplan-Meier method.


Cumulative incidence is estimated using the Kaplan-Meier method. PTLD is identified as a reported complication or cause of death on the OPTN Transplant Recipient Follow-up Form or on the Posttransplant Malignancy Form as polymorphic PTLD, monomorphic PTLD, or Hodgkin

Figure KI 163. Incidence of PTLD among pediatric kidney transplant recipients by recipient EBV status at transplant, 2007-2017
Cumulative incidence is estimated using the Kaplan-Meier method. PTLD is identified as a reported complication or cause of death on the OPTN Transplant Recipient Follow-up Form or on the Posttransplant Malignancy Form as polymorphic PTLD, monomorphic PTLD, or Hodgkin's disease. Only the earliest date of PTLD diagnosis is considered. EBV, Epstein-Barr virus.


All pediatric recipients of deceased donor kidneys, including multi-organ transplants.  Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant.

Figure KI 164. Patient death among pediatric kidney transplant recipients
All pediatric recipients of deceased donor kidneys, including multi-organ transplants. Estimates are unadjusted, computed using Kaplan-Meier competing risk methods. Recipients are followed to the earliest of kidney graft failure; kidney retransplant; return to dialysis; death; or 6 months, 1, 3, 5, or 10 years posttransplant.


Recipient survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 165. Overall patient survival among pediatric deceased donor kidney transplant recipients, 2012-2014
Recipient survival estimated using unadjusted Kaplan-Meier methods.


Recipient survival estimated using unadjusted Kaplan-Meier methods.

Figure KI 166. Patient survival among pediatric deceased donor kidney transplant recipients, 2012-2014, by recipient age
Recipient survival estimated using unadjusted Kaplan-Meier methods.


Table KI 1. Demographic characteristics of adults on the kidney transplant waiting list on December 31, 2009, December 31, 2014 and December 31, 2019
Candidates waiting for transplant on December 31 of the given year, regardless of first listing date. Distance is computed from candidate's home zip code to the transplant center.
Characteristic 2009, N 2009, Percent 2014, N 2014, Percent 2019, N 2019, Percent
Age: 18-34 years 9061 10.5% 10,106 9.4% 8363 8.3%
Age: 35-49 years 25,098 29.0% 28,110 26.1% 24,329 24.0%
Age: 50-64 years 37,281 43.0% 46,788 43.5% 44,087 43.5%
Age: ≥ 65 years 15,208 17.6% 22,529 21.0% 24,558 24.2%
Sex: Female 36,101 41.7% 43,174 40.1% 38,596 38.1%
Sex: Male 50,547 58.3% 64,359 59.9% 62,741 61.9%
Race/ethnicity: White 33,743 38.9% 39,297 36.5% 35,995 35.5%
Race/ethnicity: Black 29,888 34.5% 36,977 34.4% 32,716 32.3%
Race/ethnicity: Hispanic 15,369 17.7% 20,459 19.0% 20,977 20.7%
Race/ethnicity: Asian 6507 7.5% 9111 8.5% 9871 9.7%
Race/ethnicity: Other/unknown 1141 1.3% 1689 1.6% 1778 1.8%
Geography: Metropolitan 74,209 85.6% 93,117 86.6% 88,630 87.5%
Geography: Non-metro 12,439 14.4% 14,416 13.4% 12,707 12.5%
Distance: < 50 miles 58,079 67.0% 71,404 66.4% 67,196 66.3%
Distance: 50-<100 miles 12,952 14.9% 16,176 15.0% 15,886 15.7%
Distance: 100-<150 miles 6071 7.0% 7799 7.3% 6964 6.9%
Distance: 150-<250 miles 5644 6.5% 7159 6.7% 6225 6.1%
Distance: ≥ 250 miles 3184 3.7% 4509 4.2% 4740 4.7%
Distance: Unknown 718 0.8% 486 0.5% 326 0.3%
All candidates 86,648 100.0% 107,533 100.0% 101,337 100.0%



Table KI 2. Clinical characteristics of adults on the kidney transplant waiting list on December 31, 2009, December 31, 2014 and December 31, 2019
Candidates waiting for transplant on December 31 of the given year, regardless of first listing date. CKD, cystic kidney disease; GN, glomerulonephritis. *Diabetes status based on diagnosis and comorbid conditions.
Characteristic 2009, N 2009, Percent 2014, N 2014, Percent 2019, N 2019, Percent
Diagnosis: Diabetes 27,537 31.8% 37,849 35.2% 38,822 38.3%
Diagnosis: Hypertension 21,707 25.1% 26,020 24.2% 21,523 21.2%
Diagnosis: GN 12,814 14.8% 15,556 14.5% 14,477 14.3%
Diagnosis: CKD 7374 8.5% 9012 8.4% 8726 8.6%
Diagnosis: Other 17,216 19.9% 19,096 17.8% 17,789 17.6%
Diabetes* 35,538 41.0% 48,011 44.6% 47,442 46.8%
Blood type: A 24,643 28.4% 30,542 28.4% 27,676 27.3%
Blood type: B 14,117 16.3% 17,733 16.5% 16,921 16.7%
Blood type: AB 2504 2.9% 2979 2.8% 2534 2.5%
Blood type: O 45,384 52.4% 56,279 52.3% 54,206 53.5%
CPRA: < 1% 39,661 45.8% 64,843 60.3% 63,049 62.2%
CPRA: 1-< 20% 13,376 15.4% 9172 8.5% 9484 9.4%
CPRA: 20-< 80% 14,552 16.8% 16,027 14.9% 16,515 16.3%
CPRA: 80-< 98% 6838 7.9% 6619 6.2% 5458 5.4%
CPRA: 98-100% 7657 8.8% 10,049 9.3% 6729 6.6%
CPRA: Unknown 4564 5.3% 823 0.8% 102 0.1%
All candidates 86,648 100.0% 107,533 100.0% 101,337 100.0%



Table KI 3. Listing characteristics of adults on the kidney transplant waiting list on December 31, 2009, December 31, 2014 and December 31, 2019
Candidates waiting for transplant on December 31 of the given year, regardless of first listing date. KDPI, kidney donor profile index. *Prior to 2014, includes willingness to accept expanded criteria donor (ECD) kidney. KDPI >85% is local non-zero HLA mismatch only.
Characteristic 2009, N 2009, Percent 2014, N 2014, Percent 2019, N 2019, Percent
Transplant history: First 72,518 83.7% 92,014 85.6% 89,426 88.2%
Transplant history: Retransplant 14,130 16.3% 15,519 14.4% 11,911 11.8%
Wait time: < 1 year 29,146 33.6% 31,657 29.4% 33,298 32.9%
Wait time: 1-< 2 years 20,192 23.3% 24,519 22.8% 21,788 21.5%
Wait time: 2-< 3 years 14,176 16.4% 17,450 16.2% 14,528 14.3%
Wait time: 3-< 4 years 8805 10.2% 11,795 11.0% 10,553 10.4%
Wait time: 4-< 5 years 5302 6.1% 8061 7.5% 7279 7.2%
Wait time: ≥ 5 years 9027 10.4% 14,051 13.1% 13,891 13.7%
Will accept KDPI*>85% 39,564 45.7% 53,872 50.1% 46,145 45.5%
Tx type: Kidney alone 83,739 96.6% 104,293 97.0% 98,237 96.9%
Tx type: Kidney-pancreas 2337 2.7% 2140 2.0% 1844 1.8%
Tx type: Kidney-liver 465 0.5% 913 0.8% 983 1.0%
Tx type: Kidney-heart 95 0.1% 172 0.2% 254 0.3%
Tx type: Other 12 0.0% 15 0.0% 19 0.0%
All candidates 86,648 100.0% 107,533 100.0% 101,337 100.0%



Table KI 4. Reasons for inactive status among new adult kidney transplant listings, 2019
Candidates first listed as inactive. Each listing is counted separately. LD, living donor.
Reasons for inactive status N Percent
Candidate work-up incomplete 6952 68.7%
Too well 729 7.2%
Insurance issues 727 7.2%
Too sick 671 6.6%
Candidate choice 318 3.1%
Weight inappropriate 262 2.6%
Candidate for LD transplant only 220 2.2%
Transplant pending 122 1.2%
Medical non-compliance 53 0.5%
Unknown 33 0.3%
Inappropriate substance abuse 20 0.2%
COVID-19 Precaution 6 0.1%
Candidate could not be contacted 4 0.0%
Removal pending data correction 1 0.0%



Table KI 5. Kidney transplant waitlist activity among adults
Candidates listed at more than one center are counted once per listing. Candidates who are listed, undergo transplant, and are relisted are counted more than once. Candidates are not considered to be on the list on the day they are removed; counts on January 1 may differ from counts on December 31 of the prior year. Candidates listed for multi-organ transplants are included.
Waiting list state 2017 2018 2019
Patients at start of year 104,145 101,348 100,998
Patients added during year 36,725 40,157 42,934
Patients removed during year 39,451 40,439 42,579
Patients at end of year 101,419 101,066 101,353



Table KI 6. Removal reason among adult kidney transplant candidates
Removal reason as reported to the OPTN. Candidates with death dates that precede removal dates are assumed to have died waiting.
Removal reason 2017 2018 2019
Deceased donor transplant 14,194 14,942 16,754
Living donor transplant 5559 6145 6605
Transplant outside US 79 59 64
Patient died 4671 4451 4130
Patient refused transplant 532 455 396
Improved, transplant not needed 224 197 205
Too sick for transplant 4746 4435 4259
Other 9446 9755 10,166



Table KI 7. Living kidney donor deaths in the first year after donoation, 2015-2019, by number of days after donation
Living kidney donors. Number of deaths reported to OPTN or Social Security Administration. Donation-related deaths are included in the Medical category.
Cause 0-30 days 31-90 days 91-365 days
Suicide 0 1 3
Accident/homicide 0 0 7
Overdose 0 1 0
Medical 2 0 1
Cancer 0 0 0
Unknown 0 1 1
TOTAL 2 3 12



Table KI 8. Demographic characteristics of adult kidney transplant recipients, 2019
Kidney transplant recipients, including retransplants. Distance is computed from recipient's home zip code to the transplant center.
Characteristic Deceased, N Deceased, Percent Living, N Living, Percent All, N All, Percent
Age: 18-34 years 1795 10.6% 1153 17.4% 2948 12.5%
Age: 35-49 years 4322 25.6% 1758 26.5% 6080 25.9%
Age: 50-64 years 6920 41.0% 2429 36.7% 9349 39.8%
Age: ≥ 65 years 3847 22.8% 1286 19.4% 5133 21.8%
Sex: Female 6694 39.6% 2464 37.2% 9158 39.0%
Sex: Male 10,190 60.4% 4162 62.8% 14,352 61.0%
Race/ethnicity: White 6414 38.0% 4232 63.9% 10,646 45.3%
Race/ethnicity: Black 5535 32.8% 867 13.1% 6402 27.2%
Race/ethnicity: Hispanic 3302 19.6% 1019 15.4% 4321 18.4%
Race/ethnicity: Asian 1329 7.9% 411 6.2% 1740 7.4%
Race/ethnicity: Other/unknown 304 1.8% 97 1.5% 401 1.7%
Insurance: Private 3957 23.4% 3579 54.0% 7536 32.1%
Insurance: Medicare 11,433 67.7% 2598 39.2% 14,031 59.7%
Insurance: Medicaid 1085 6.4% 299 4.5% 1384 5.9%
Insurance: Other government 370 2.2% 122 1.8% 492 2.1%
Insurance: Unknown 39 0.2% 28 0.4% 67 0.3%
Geography: Metropolitan 14,546 86.2% 5687 85.8% 20,233 86.1%
Geography: Non-metro 2338 13.8% 939 14.2% 3277 13.9%
Distance: < 50 miles 11,081 65.6% 4322 65.2% 15,403 65.5%
Distance: 50-<100 miles 2668 15.8% 1085 16.4% 3753 16.0%
Distance: 100-<150 miles 1310 7.8% 475 7.2% 1785 7.6%
Distance: 150-<250 miles 957 5.7% 361 5.4% 1318 5.6%
Distance: ≥ 250 miles 797 4.7% 349 5.3% 1146 4.9%
Distance: Unknown 71 0.4% 34 0.5% 105 0.4%
All recipients 16,884 100.0% 6626 100.0% 23,510 100.0%



Table KI 9. Clinical characteristics of adult kidney transplant recipients, 2019
Kidney transplant recipients, including retransplants. CKD, cystic kidney disease; GN, glomerulonephritis.
Characteristic Deceased, N Deceased, Percent Living, N Living, Percent All, N All, Percent
Diagnosis: Diabetes 5727 33.9% 1663 25.1% 7390 31.4%
Diagnosis: Hypertension 3824 22.6% 1019 15.4% 4843 20.6%
Diagnosis: GN 2576 15.3% 1539 23.2% 4115 17.5%
Diagnosis: CKD 1707 10.1% 1128 17.0% 2835 12.1%
Diagnosis: Other 3050 18.1% 1277 19.3% 4327 18.4%
Blood type: A 5883 34.8% 2542 38.4% 8425 35.8%
Blood type: B 2341 13.9% 912 13.8% 3253 13.8%
Blood type: AB 905 5.4% 282 4.3% 1187 5.0%
Blood type: O 7755 45.9% 2890 43.6% 10,645 45.3%
Dialysis time: None 2126 12.6% 2161 32.6% 4287 18.2%
Dialysis time: < 1 year 1290 7.6% 1431 21.6% 2721 11.6%
Dialysis time: 1-< 3 years 3370 20.0% 1627 24.6% 4997 21.3%
Dialysis time: 3-< 5 years 3375 20.0% 556 8.4% 3931 16.7%
Dialysis time: ≥ 5 years 6723 39.8% 851 12.8% 7574 32.2%
CPRA: < 1% 9977 59.1% 4818 72.7% 14,795 62.9%
CPRA: 1-< 20% 1480 8.8% 629 9.5% 2109 9.0%
CPRA: 20-< 80% 2798 16.6% 910 13.7% 3708 15.8%
CPRA: 80-< 98% 1230 7.3% 194 2.9% 1424 6.1%
CPRA: 98-100% 1399 8.3% 73 1.1% 1472 6.3%
CPRA: Unknown 0 0.0% 2 0.0% 2 0.0%
All recipients 16,884 100.0% 6626 100.0% 23,510 100.0%



Table KI 10. Transplant characteristics of adult kidney transplant recipients, 2019
Kidney transplant recipients, including retransplants. DBD, donation after brain death; DCD, donation after circulatory death; KDPI, kidney donor profile index. DCD status and KDPI scores apply to deceased donor transplants only.
Characteristic Deceased, N Deceased, Percent Living, N Living, Percent All, N All, Percent
Wait time: None (preemptive) 121 0.7% 145 2.2% 266 1.1%
Wait time: < 1 year 7445 44.1% 4082 61.6% 11,527 49.0%
Wait time: 1-< 3 years 4174 24.7% 1829 27.6% 6003 25.5%
Wait time: 3-< 5 years 2631 15.6% 400 6.0% 3031 12.9%
Wait time: ≥ 5 years 2513 14.9% 170 2.6% 2683 11.4%
KDPI: ≤ 20% 3824 22.7%
KDPI: 21-34% 2769 16.4%
KDPI: 35-85% 9005 53.3%
KDPI: > 85% 1284 7.6%
DCD status: DBD 12,774 75.7%
DCD status: DCD 4110 24.3%
DGF: None 11,966 70.9% 6428 97.0% 18,394 78.2%
DGF: Yes 4918 29.1% 198 3.0% 5116 21.8%
Transplant history: First 15,055 89.2% 6018 90.8% 21,073 89.6%
Transplant history: Retransplant 1829 10.8% 608 9.2% 2437 10.4%
Tx type: Kidney only 15,074 89.3% 6626 100.0% 21,700 92.3%
Tx type: Kidney-pancreas 867 5.1% 0 0.0% 867 3.7%
Tx type: Kidney-liver 704 4.2% 0 0.0% 704 3.0%
Tx type: Kidney-heart 213 1.3% 0 0.0% 213 0.9%
Tx type: Kidney-lung 13 0.1% 0 0.0% 13 0.1%
Tx type: Other 13 0.1% 0 0.0% 13 0.1%
All recipients 16,884 100.0% 6626 100.0% 23,510 100.0%



Table KI 11. Adult deceased donor kidney donor-recipient serology matching, 2017-2019
Donor serology is reported on the OPTN Donor Registration Form and recipient serology on the OPTN Transplant Recipient Registration Form. There may be multiple fields per serology. Any evidence for a positive serology is treated as positive for that serology. Donor HCV NAT data are shown by recipient HCV antibody status. CMV, cytomegalovirus; EBV, Epstein-Barr virus; HBsAg, hepatitis B surace antigen; HCV, hepatitis C virus; HIV, human immunodeficiency virus; NAT, nucleic acid test.
Donor Recipient CMV EBV HBsAg HCV antibody HCV NAT
D- R- 13.5% 0.7% 97.7% 88.6% 90.9%
D- R+ 25.7% 7.8% 1.4% 3.4% 3.8%
D- R unk 0.2% 0.5% 0.7% 0.8% 0.8%
D+ R- 18.2% 6.0% 0.1% 5.1% 2.8%
D+ R+ 41.4% 82.2% 0.0% 2.0% 1.6%
D+ R unk 0.4% 2.6% 0.0% 0.1% 0.1%
D unk R- 0.2% 0.0% 0.1% 0.0% 0.0%
D unk R+ 0.3% 0.1% 0.0% 0.0% 0.0%
D unk R unk 0.0% 0.0% 0.0% 0.0% 0.0%



Table KI 12. Adult living donor kidney donor-recipient serology matching, 2017-2019
Donor serology is reported on the OPTN Donor Registration Form and recipient serology on the OPTN Transplant Recipient Registration Form. There may be multiple fields per serology. Any evidence for a positive serology is treated as positive for that serology. Donor HCV NAT data are shown by recipient HCV antibody status. CMV, cytomegalovirus; EBV, Epstein-Barr virus; HBsAg, hepatitis B surface antigen; HCV, hepatitis C virus; HIV, human immunodeficiency virus; NAT, nucleic acid test.
Donor Recipient CMV EBV HBsAg HCV antibody HCV NAT
D- R- 25.2% 1.2% 96.2% 94.4% 87.2%
D- R+ 20.7% 6.9% 0.9% 1.8% 1.6%
D- R unk 0.3% 0.2% 0.6% 0.9% 0.8%
D+ R- 17.9% 7.1% 0.4% 0.6% 0.1%
D+ R+ 32.6% 81.3% 0.0% 0.0% 0.0%
D+ R unk 0.5% 1.5% 0.0% 0.0% 0.0%
D unk R- 1.3% 0.2% 1.9% 2.2% 9.9%
D unk R+ 1.6% 1.5% 0.0% 0.0% 0.2%
D unk R unk 0.0% 0.1% 0.0% 0.0% 0.1%



Table KI 13. Reasons for inactive status among new pediatric kidney transplant listings, 2019
Candidates first listed as inactive. Each listing is counted separately. LD, living donor.
Reasons for inactive status N Percent
Candidate work-up incomplete 346 52.4%
Candidate for LD transplant only 104 15.8%
Too well 102 15.5%
Candidate choice 43 6.5%
Too sick 34 5.2%
Insurance issues 9 1.4%
Weight inappropriate 9 1.4%
Medical non-compliance 8 1.2%
Transplant pending 3 0.5%
COVID-19 Precaution 1 0.2%
Candidate could not be contacted 1 0.2%



Table KI 14. Demographic characteristics of pediatric candidates on the kidney transplant waiting list on December 31, 2009, December 31, 2014, and December 31, 2019
Candidates aged younger than 18 years waiting for transplant on December 31 of given year, regardless of first listing date. Age calculated at snapshot. Candidates listed as children who turned 18 before the cohort date are excluded. Distance is computed from candidate's home zip code to the transplant center.
Characteristic 2009, N 2009, Percent 2014, N 2014, Percent 2019, N 2019, Percent
Age: < 1 year 6 0.8% 3 0.3% 1 0.1%
Age: 1-5 years 137 17.4% 227 22.7% 222 21.3%
Age: 6-10 years 140 17.8% 191 19.1% 217 20.8%
Age: 11-17 years 503 64.0% 581 58.0% 604 57.9%
Sex: Female 325 41.3% 430 42.9% 406 38.9%
Sex: Male 461 58.7% 572 57.1% 638 61.1%
Race/ethnicity: White 298 37.9% 415 41.4% 433 41.5%
Race/ethnicity: Black 203 25.8% 217 21.7% 207 19.8%
Race/ethnicity: Hispanic 251 31.9% 302 30.1% 286 27.4%
Race/ethnicity: Asian 24 3.1% 51 5.1% 83 8.0%
Race/ethnicity: Other/unknown 10 1.3% 17 1.7% 35 3.4%
Geography: Metropolitan 697 88.7% 871 86.9% 911 87.3%
Geography: Non-metro 89 11.3% 131 13.1% 133 12.7%
Distance: < 50 miles 503 64.0% 633 63.2% 675 64.7%
Distance: 50-<100 miles 126 16.0% 147 14.7% 160 15.3%
Distance: 100-<150 miles 67 8.5% 86 8.6% 64 6.1%
Distance: 150-<250 miles 52 6.6% 70 7.0% 84 8.0%
Distance: ≥ 250 miles 35 4.5% 54 5.4% 56 5.4%
Distance: Unknown 3 0.4% 12 1.2% 5 0.5%
All candidates 786 100.0% 1002 100.0% 1044 100.0%



Table KI 15. Clinical characteristics of pediatric candidates on the kidney transplant waiting list on December 31, 2009, December 31, 2014, and December 31, 2019
Candidates aged younger than 18 years waiting for transplant on December 31 of the given year, regardless of first listing date. Candidates listed as children who turned 18 before the cohort date are excluded. FSGS, focal segmental glomerulosclerosis; GN, glomerulonephritis; CAKUT, congenital anomalies of the kidney and urinary tract.
Characteristic 2009, N 2009, Percent 2014, N 2014, Percent 2019, N 2019, Percent
Diagnosis: FSGS 116 14.8% 93 9.3% 84 8.0%
Diagnosis: GN 78 9.9% 85 8.5% 63 6.0%
Diagnosis: CAKUT 214 27.2% 372 37.1% 388 37.2%
Diagnosis: Other 378 48.1% 452 45.1% 509 48.8%
Blood type: A 237 30.2% 310 30.9% 304 29.1%
Blood type: B 134 17.0% 153 15.3% 167 16.0%
Blood type: AB 18 2.3% 29 2.9% 27 2.6%
Blood type: O 397 50.5% 510 50.9% 546 52.3%
CPRA: < 1% 401 51.0% 643 64.2% 730 69.9%
CPRA: 1-< 20% 90 11.5% 66 6.6% 81 7.8%
CPRA: 20-< 80% 106 13.5% 147 14.7% 138 13.2%
CPRA: 80-< 98% 72 9.2% 52 5.2% 37 3.5%
CPRA: 98-100% 61 7.8% 88 8.8% 58 5.6%
CPRA: Unknown 56 7.1% 6 0.6% 0 0.0%
All candidates 786 100.0% 1002 100.0% 1044 100.0%



Table KI 16. Listing characteristics of pediatric candidates on the kidney transplant waiting list on December 31, 2009, December 31, 2014, and December 31, 2019
Candidates aged younger than 18 years waiting for transplant on December 31 of the given year, regardless of first listing date. Candidates listed as children who turned 18 before the cohort date are excluded.
Characteristic 2009, N 2009, Percent 2014, N 2014, Percent 2019, N 2019, Percent
Transplant history: First 577 73.4% 798 79.6% 904 86.6%
Transplant history: Retransplant 209 26.6% 204 20.4% 140 13.4%
Wait time: < 1 year 443 56.4% 559 55.8% 542 51.9%
Wait time: 1-< 2 years 170 21.6% 232 23.2% 233 22.3%
Wait time: 2-< 3 years 88 11.2% 98 9.8% 120 11.5%
Wait time: 3-< 4 years 38 4.8% 42 4.2% 50 4.8%
Wait time: 4-< 5 years 30 3.8% 30 3.0% 47 4.5%
Wait time: ≥ 5 years 17 2.2% 41 4.1% 52 5.0%
Tx type: Kidney alone 771 98.1% 976 97.4% 1029 98.6%
Tx type: Kidney-pancreas 2 0.3% 0 0.0% 0 0.0%
Tx type: Kidney-liver 8 1.0% 19 1.9% 12 1.1%
Tx type: Kidney-heart 2 0.3% 4 0.4% 2 0.2%
Tx type: Other 3 0.4% 3 0.3% 1 0.1%
All candidates 786 100.0% 1002 100.0% 1044 100.0%



Table KI 17. Kidney transplant waitlist activity among pediatric candidates
Candidates who are listed, undergo transplant, and are relisted are counted more than once. Candidates are not considered to be on the list on the day they are removed; counts on January 1 may differ from counts on December 31 of the prior year. Candidates listed for multi-organ transplants are included.
Waiting list state 2017 2018 2019
Patients at start of year 1463 1533 1548
Patients added during year 1083 1047 1030
Patients removed during year 1012 1031 1024
Patients at end of year 1534 1549 1554



Table KI 18. Removal reason among pediatric kidney transplant candidates
Removal reason as reported to the OPTN. Candidates with death dates that precede removal dates are assumed to have died waiting.
Removal reason 2017 2018 2019
Deceased donor transplant 605 577 610
Living donor transplant 251 297 262
Transplant outside US 0 1 0
Patient died 15 24 18
Patient refused transplant 3 0 3
Improved, transplant not needed 6 10 6
Too sick for transplant 14 9 10
Other 118 113 115



Table KI 19. Demographic characteristics of pediatric kidney transplant recipients, 2017-2019
Pediatric kidney transplant recipients, including retransplants. Distance is computed from recipient's home zip code to the transplant center.
Characteristic Deceased, N Deceased, Percent Living, N Living, Percent All, N All, Percent
Age: 1-5 years 282 18.6% 234 31.2% 516 22.8%
Age: 6-10 years 303 20.0% 146 19.5% 449 19.8%
Age: 11-17 years 932 61.4% 370 49.3% 1302 57.4%
Sex: Female 626 41.3% 277 36.9% 903 39.8%
Sex: Male 891 58.7% 473 63.1% 1364 60.2%
Race/ethnicity: White 557 36.7% 523 69.7% 1080 47.6%
Race/ethnicity: Black 343 22.6% 64 8.5% 407 18.0%
Race/ethnicity: Hispanic 496 32.7% 124 16.5% 620 27.3%
Race/ethnicity: Asian 72 4.7% 25 3.3% 97 4.3%
Race/ethnicity: Other/unknown 49 3.2% 14 1.9% 63 2.8%
Insurance: Private 387 25.5% 415 55.3% 802 35.4%
Insurance: Medicare 375 24.7% 120 16.0% 495 21.8%
Insurance: Medicaid 637 42.0% 179 23.9% 816 36.0%
Insurance: Other government 102 6.7% 26 3.5% 128 5.6%
Insurance: Unknown 16 1.1% 10 1.3% 26 1.1%
Geography: Metropolitan 1267 83.5% 626 83.5% 1893 83.5%
Geography: Non-metro 250 16.5% 124 16.5% 374 16.5%
Distance: < 50 miles 929 61.2% 449 59.9% 1378 60.8%
Distance: 50-<100 miles 239 15.8% 126 16.8% 365 16.1%
Distance: 100-<150 miles 147 9.7% 59 7.9% 206 9.1%
Distance: 150-<250 miles 112 7.4% 60 8.0% 172 7.6%
Distance: ≥ 250 miles 79 5.2% 48 6.4% 127 5.6%
Distance: Unknown 11 0.7% 8 1.1% 19 0.8%
All recipients 1517 100.0% 750 100.0% 2267 100.0%



Table KI 20. Clinicial characteristics of pediatric kidney transplant recipients, 2017-2019
Pediatric kidney transplant recipients, including retransplants. Diagnosis categories follow North American Pediatric Renal Trials and Collaborative Studies recommendations. FSGS, focal segmental glomerulosclerosis; GN, glomerulonephritis; CAKUT, congenital anomalies of the kidney and urinary tract.
Characteristic Deceased, N Deceased, Percent Living, N Living, Percent All, N All, Percent
Diagnosis: FSGS 195 12.9% 78 10.4% 273 12.0%
Diagnosis: GN 135 8.9% 61 8.1% 196 8.6%
Diagnosis: CAKUT 472 31.1% 269 35.9% 741 32.7%
Diagnosis: Other 715 47.1% 342 45.6% 1057 46.6%
Blood type: A 441 29.1% 284 37.9% 725 32.0%
Blood type: B 178 11.7% 113 15.1% 291 12.8%
Blood type: AB 55 3.6% 23 3.1% 78 3.4%
Blood type: O 843 55.6% 330 44.0% 1173 51.7%
Dialysis time: None 388 25.6% 301 40.1% 689 30.4%
Dialysis time: < 1 year 337 22.2% 191 25.5% 528 23.3%
Dialysis time: 1-< 3 years 479 31.6% 175 23.3% 654 28.8%
Dialysis time: 3-< 5 years 147 9.7% 28 3.7% 175 7.7%
Dialysis time: ≥ 5 years 166 10.9% 55 7.3% 221 9.7%
CPRA: < 1% 1115 73.5% 544 72.5% 1659 73.2%
CPRA: 1-< 20% 142 9.4% 84 11.2% 226 10.0%
CPRA: 20-< 80% 195 12.9% 98 13.1% 293 12.9%
CPRA: 80-< 98% 33 2.2% 15 2.0% 48 2.1%
CPRA: 98-100% 32 2.1% 7 0.9% 39 1.7%
CPRA: Unknown 0 0.0% 2 0.3% 2 0.1%
All recipients 1517 100.0% 750 100.0% 2267 100.0%



Table KI 21. Transplant characteristics of pediatric kidney transplant recipients, 2017-2019
Pediatric kidney transplant recipients, including retransplants. DBD, donation after brain death; DCD, donation after circulatory death; DGF, delayed graft function; KDPI, kidney donor profile index. DCD status and KDPI scores apply to deceased donor transplants only.
Characteristic Deceased, N Deceased, Percent Living, N Living, Percent All, N All, Percent
Wait time: None (preemptive) 8 0.5% 31 4.1% 39 1.7%
Wait time: < 1 year 1050 69.2% 558 74.4% 1608 70.9%
Wait time: 1-< 3 years 366 24.1% 134 17.9% 500 22.1%
Wait time: 3-< 5 years 75 4.9% 22 2.9% 97 4.3%
Wait time: ≥ 5 years 18 1.2% 5 0.7% 23 1.0%
KDPI: ≤ 20% 1182 77.9%
KDPI: 21-34% 272 17.9%
KDPI: 35-85% 62 4.1%
KDPI: > 85% 1 0.1%
DCD status: DBD 1444 95.2%
DCD status: DCD 73 4.8%
DGF: None 1407 92.7% 727 96.9% 2134 94.1%
DGF: Yes 110 7.3% 23 3.1% 133 5.9%
Transplant history: First 1393 91.8% 701 93.5% 2094 92.4%
Transplant history: Retransplant 124 8.2% 49 6.5% 173 7.6%
Tx type: Kidney only 1442 95.1% 750 100.0% 2192 96.7%
Tx type: Kidney-pancreas 2 0.1% 0 0.0% 2 0.1%
Tx type: Kidney-liver 59 3.9% 0 0.0% 59 2.6%
Tx type: Kidney-heart 10 0.7% 0 0.0% 10 0.4%
Tx type: Other 4 0.3% 0 0.0% 4 0.2%
All recipients 1517 100.0% 750 100.0% 2267 100.0%



Table KI 22. Pediatric deceased donor kidney donor-recipient serology matching, 2017-2019
Donor serology is reported on the OPTN Donor Registration Form and recipient serology on the OPTN Transplant Recipient Registration Form. There may be multiple fields per serology. Any evidence for a positive serology is treated as positive for that serology. CMV, cytomegalovirus; EBV, Epstein-Barr virus.
Donor Recipient CMV EBV
D- R- 25.9% 6.0%
D- R+ 14.7% 7.4%
D- R unk 0.6% 0.1%
D+ R- 37.7% 38.2%
D+ R+ 19.8% 47.2%
D+ R unk 0.5% 1.1%
D unk R- 0.5% 0.0%
D unk R+ 0.4% 0.0%
D unk R unk 0.0% 0.0%



Table KI 23. Pediatric living donor kidney donor-recipient serology matching, 2017-2019
Donor serology is reported on the OPTN Donor Registration Form and recipient serology on the OPTN Transplant Recipient Registration Form. There may be multiple fields per serology. Any evidence for a positive serology is treated as positive for that serology. CMV, cytomegalovirus; EBV, Epstein-Barr virus.
Donor Recipient CMV EBV
D- R- 36.9% 5.3%
D- R+ 8.5% 3.6%
D- R unk 0.1% 0.1%
D+ R- 30.7% 52.5%
D+ R+ 17.6% 33.3%
D+ R unk 0.5% 1.5%
D unk R- 4.1% 2.3%
D unk R+ 1.5% 1.3%
D unk R unk 0.0% 0.0%