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OPTN/SRTR 2022 Annual Data Report: Introduction

OPTN/SRTR 2022 Annual Data Report: Introduction

David P. Schladt1, Ajay K. Israni1,2,3

1Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN

2Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN

3Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN

Abstract

The OPTN/SRTR 2022 Annual Data Report presents the status of the solid organ transplant system in the United States from 2011 through 2022. Organ-specific chapters are presented for kidney, pancreas, liver, intestine, heart, and lung transplant. Each organ-specific chapter is organized to present waitlist information, donor information (both deceased and living, as appropriate), transplant information, and patient outcomes. Data pertaining to pediatric patients are generally presented separately from the adult data. In addition to the organ-specific chapters, the reader will find chapters dedicated to deceased organ donation, vascularized composite allografts, and the COVID-19 pandemic. The data presented in the Annual Data Report are descriptive in nature. In other words, most tables and figures present raw data without statistical adjustment for possible confounding or changes over time. Therefore, the reader should keep in mind the observational nature of the data when attempting to draw inferences before trying to ascribe a cause to any observed patterns or trends. This introduction provides a brief overview of trends in waitlist and transplant activity from 2012 through 2022. More detailed descriptions can be found in the respective organ-specific chapters.

Keywords: Allocation, outcomes, transplant, waiting list

7 Summary

In 2022, the transplant system set another record for the number of solid organ transplants performed in the country. Over the past decade (2012-2022), the number of kidney transplants increased by 52%; liver transplants, by 52%; heart transplants, by 73%; and lung transplants, by 54%. During the same period, there was a decline of 12% and 23% for pancreas and intestine transplants, respectively, likely due to improvements in medical management for such patients. In 2022, the number of candidates on the waiting list increased for kidney, kidney-pancreas, heart, and lung transplants. In the same year, the number of candidates on the waiting list decreased for liver, intestine, and pancreas alone transplants. In 2022, the number of newly listed candidates increased for kidney, heart, intestine, kidney-pancreas, and lung transplants and decreased for liver and pancreas-alone transplants. The growth in transplants overall was outpaced by the waitlist additions, thereby highlighting the supply-demand imbalance in solid organ transplantation. The increase in the number of organs recovered for the purpose of transplant but ultimately not transplanted for kidney and pancreas also represents an opportunity for improving efficiency in the system. Each organ-specific chapter and the chapters dedicated to specific topics in this Annual Data Report present a more detailed look at the status of organ donation and transplantation in the United States.

List of Figures




**All candidates on the kidney or liver waiting list.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list any time during the year.

Figure INT 1: All candidates on the kidney or liver waiting list. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list any time during the year.




**All candidates on the waiting list for organs other than isolated kidney or liver.** Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list any time during the year. PAK, pancreas after kidney; PTA, pancreas transplant alone.

Figure INT 2: All candidates on the waiting list for organs other than isolated kidney or liver. Candidates listed at multiple centers are counted once per listing. Includes active and inactive candidates on the list any time during the year. PAK, pancreas after kidney; PTA, pancreas transplant alone.




**New candidates added to the kidney or liver waiting list during the year.** 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.

Figure INT 3: New candidates added to the kidney or liver waiting list during the year. 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.




**New candidates added to the waiting list during the year for organs other than isolated kidney or liver.** 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. PAK, pancreas after kidney; PTA, pancreas transplant alone.

Figure INT 4: New candidates added to the waiting list during the year for organs other than isolated kidney or liver. 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. PAK, pancreas after kidney; PTA, pancreas transplant alone.




**Total counts of kidney or liver transplants.** Kidney: patients undergoing kidney or simultaneous pancreas-kidney transplant. Retransplants and multiorgan transplants are included.

Figure INT 5: Total counts of kidney or liver transplants. Kidney: patients undergoing kidney or simultaneous pancreas-kidney transplant. Retransplants and multiorgan transplants are included.




**Total counts of transplants for organs other than isolated kidney or liver.** Pancreas: patients undergoing pancreas or simultaneous pancreas-kidney transplant. Heart: patients undergoing heart or heart-lung transplant. Lung: patients undergoing lung or heart-lung transplant. Retransplants and multiorgan transplants are included.

Figure INT 6: Total counts of transplants for organs other than isolated kidney or liver. Pancreas: patients undergoing pancreas or simultaneous pancreas-kidney transplant. Heart: patients undergoing heart or heart-lung transplant. Lung: patients undergoing lung or heart-lung transplant. Retransplants and multiorgan transplants are included.