Kidney Transplant

A kidney transplant is a surgical procedure to remove a kidney that is no longer functioning properly and replace it with a healthy kidney from a donor.

Kidney transplant is a treatment option for people who have kidney failure. Kidneys remove excess fluid and waste from the blood. With kidney failure, kidneys lose this filtering ability and dangerous levels of fluid and waste build up. Kidney failure can be caused by diabetes, chronic, uncontrolled high blood pressure or chronic glomerulonephritis (inflammation and eventual scarring within the kidney).

Only one donated kidney is needed to replace two failed kidneys, making it possible to transplant a kidney from a living donor. If a compatible living donor isn't available for a kidney transplant, a patient's name may be placed on a kidney transplant waiting list to receive a kidney from a deceased donor. The wait could be a year or more.

Procedure volume is the number of times a procedure was performed and is often used to assess clinical experience and expertise. Studies have linked higher volumes with more successful outcomes for some types of procedures.

Number of Kidney Transplants

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Why is This Measure Important?

Health systems that perform a high number of kidney transplants are more likely to have better outcomes, such as better survival rates. Unfortunately, there is no standard or agreed upon threshold that defines high volume, so it is important to consider volume along with other measures, like process and outcome measures. This is a measure of the volume, or number of kidney transplants.

How is UMHS Performing?

Surgeons at the University of Michigan Health System perform an average of 216 kidney transplants each year. According to the U.S. Scientific Registry of Transplant Recipients, UMHS' transplant rates was 26.1 for 2013 which is greater than the national rate of 12.6. Our volume is higher demonstrating that UMHS has considerable experience in kidney transplantation

UMHS Source: Hospital administrative data.
Comparison Group Source: None.

The following graph can be used to assess our efforts to reduce the time from evaluating a potential transplant candidate to putting him/her on the transplant waiting list.

Time from Patient Evaluation to Waiting List
Lower Value = Better Performance

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Why is This Measure Important?

It takes time for a kidney transplant candidate to receive a kidney from a donor. As a consequence, it is important to minimize the time from evaluating a potential transplant candidate to putting him/her on the transplant waiting list. This is a measure of the time from evaluation to wait listing for kidney transplant candidates. For this measure, shorter times mean better performance.

How is UMHS Performing?

The graph shows that the median number of days from evaluation to wait listing a patient for transplant is variable. The University of Michigan Health System implemented steps to improve the efficiency of this process in mid-2009. Results improved (decreased) initially, but then increased again. Our team has analyzed and is continuing to work to streamline this process.

UMHS Source: Hospital Organ Transplant Information System.
Comparison Group Source: Institutional goal set by UMHS.

In this section, we evaluate the success of the kidney transplants by measuring several outcomes, including patient and graft survival. Because the severity of disease differs between patients, some patients have a higher risk of death. So, we compare our actual performance to what is expected given the risk of the patients we treat. The expected survival rate is provided by the U.S. Scientific Registry of Transplant Recipients (SRTR). For all measures except waitlist mortality, percentages that are higher than the SRTR expected rate mean better performance.

Transplant Rate
Higher Value = Better Performance

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Why is This Measure Important?

The transplant rate is the percentage of patients on the waiting list for transplant who received a transplant. The actual transplant rate for the University of Michigan Health System is compared to the expected rate for our institution calculated by the U.S. Scientific Registry for Transplant Recipients (SRTR). Although the SRTR expected rates are adjusted to account for the severity of illness of our waitlisted patients, the adjustment is not perfect. In this graph, a percentage that is higher than the SRTR expected rate means better performance.

(Note: The rate accounts for the amount of time patients are waitlisted and is expressed as the number of transplants per patient year on the waiting list.)

How is UMHS Performing?

The University of Michigan Health System had more transplants than expected based on the national experience in all five years reported. However, the difference between actual and expected rates in all five years is not statistically significant.

UMHS Source: Hospital Organ Transplant Information System.
Comparison Group Source: Scientific Registry of Transplant Recipients (SRTR).

Patient Survival Rates After Transplant - Adults
Higher Value = Better Performance

Details

Why is This Measure Important?

Patient survival is a measure of the success of the kidney transplant. This measure represents the percentage of adult patients who survived 1 month, 1 year and 3 years after kidney transplant. The actual patient survival rates for the University of Michigan Health System are compared to the expected rates for our institution calculated by the U.S. Scientific Registry for Transplant Recipients (SRTR). Although the SRTR expected rates are adjusted to account for the severity of illness of our transplant population, the adjustment is not perfect. In this graph, a percentage that is higher than the SRTR expected rate means better performance.

How is UMHS Performing?

The University of Michigan Health System's adult patient survival rate is about the same as expected after 1 month but is lower than expected at 1 and 3 years after kidney transplant, based on results from SRTR. The difference in the rates are not statistically significant. An examination of deaths at 1 year after kidney transplant revealed that a significant portion of patients died from causes unrelated to the transplant.

UMHS Source: Hospital Organ Transplant Information System.
Comparison Group Source: Scientific Registry of Transplant Recipients (SRTR).

Waitlist Mortality
Lower Value = Better Performance

Details

Why is This Measure Important?

This is a measure of the number of patients who died while waiting for a transplant. The results for this measure may be influenced by the characteristics of the patients on the waitlist and availability of organs from suitable donors. The actual waitlist mortality rate for the University of Michigan Health System is compared to the expected rate for our institution calculated by the U.S. Scientific Registry for Transplant Recipients (SRTR). Although the SRTR expected rates are adjusted to account for the severity of illness of our waitlisted patients, the adjustment is not perfect. In this graph, a percentage that is lower than the SRTR expected rate means better performance.

(Note: The rate accounts for the amount of time patients are waitlisted and is expressed as the number of deaths per 1,000 patient years on the waiting list.)

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How is UMHS Performing?

The University of Michigan Health System had slightly lower mortality than expected based on the national experience in the most recent year reported. However, the difference between actual and expected rates in all five years is not statistically significant.

UMHS Source: Hospital Organ Transplant Information System.
Comparison Group Source: Scientific Registry of Transplant Recipients (SRTR).

Graft Survival Rates After Transplant - Adults
Higher Value = Better Performance

Details

Why is This Measure Important?

A "graft" refers to the transplanted organ. Graft survival is a measure of the success of the kidney transplant. Sometimes the transplant, or graft, may fail, but the person may survive. This measure represents the percentage of grafts for adult patients that survived 1 month, 1 year and 3 years after kidney transplant. The actual graft survival rate for the University of Michigan Health System is compared to the expected rate for our institution calculated by the US Scientific Registry for Transplant Recipients (SRTR). Although the SRTR expected rates are adjusted to account for the severity of illness of our transplant population, the adjustment is not perfect. In this graph, a percentage that is higher than the SRTR expected rate means better performance.

How is UMHS Performing?

The University of Michigan Health System's graft survival rate is about the same as expected after 1 month and 3 years but is higher than expected at 1 year after kidney transplant, based on results from SRTR. The difference in the rate at 1 year after transplant is statistically significant.

UMHS Source: Hospital Organ Transplant Information System.
Comparison Group Source: Scientific Registry of Transplant Recipients (SRTR.