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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 15 of 15 Research Studies DisplayedBae S, Johnson M, Massie AB
Mortality and access to kidney transplantation in patients with sickle cell disease-associated kidney failure.
Patients with sickle cell disease-associated kidney failure have high mortality, which might be lowered by kidney transplantation. However, because they show higher post-transplant mortality compared with patients with other kidney failure etiologies, kidney transplantation remains controversial in this population. In this study, the investigators aimed to quantify the decrease in mortality associated with transplantation in this population and determine the chance of receiving transplantation with sickle cell disease as the cause of kidney failure as compared with other etiologies of kidney failure.
AHRQ-funded; HS024600.
Citation: Bae S, Johnson M, Massie AB .
Mortality and access to kidney transplantation in patients with sickle cell disease-associated kidney failure.
Clin J Am Soc Nephrol 2021 Mar 8;16(3):407-14. doi: 10.2215/cjn.02720320..
Keywords: Transplantation, Access to Care, Kidney Disease and Health, Mortality
Pennington KM, Dykhoff HJ, Yao X
The impact of antifungal prophylaxis in lung transplant recipients.
This study evaluated the effect of antifungal prophylaxis on all-cause mortality and invasive fungal infections (IFI) on lung transplant recipients. Administrative claims data was used to identify adult patients who underwent lung transplantation between 2005 and 2018. The authors identified 662 lung transplant recipients. All-cause mortality was found to be significantly lower in those receiving antifungal prophylaxis compared to those who did not. Patients receiving antifungal prophylaxis also had a lower rate of IFI, but it was not statistically significant.
AHRQ-funded; HS025164; HS025402; HS025517; HS024075.
Citation: Pennington KM, Dykhoff HJ, Yao X .
The impact of antifungal prophylaxis in lung transplant recipients.
Ann Am Thorac Soc 2021 Mar;18(3):468-76. doi: 10.1513/AnnalsATS.202003-267OC..
Keywords: Transplantation, Surgery, Medication, Prevention, Respiratory Conditions, Mortality, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Stepkowski SM, Mierzejewska B, Fumo D
The 6-year clinical outcomes for patients registered in a multiregional United States Kidney Paired Donation program - a retrospective study.
This retrospective study examined 6-year clinical outcomes for patients registered in a multiregional US Kidney Paired Donation (KPF) program. A total of 1121 end-stage renal disease patients who registered with their willing/incompatible living donors for kidney exchange were followed. Out of the 1121, 65% were transplanted with 37% of them in kidney paired donations, 10% with compatible live donors, and 18% with deceased donors. The remaining patients withdrew due to illness or death, or were still waiting (20%). There were similar survival rates with the different donor methods.
AHRQ-funded; HS020610.
Citation: Stepkowski SM, Mierzejewska B, Fumo D .
The 6-year clinical outcomes for patients registered in a multiregional United States Kidney Paired Donation program - a retrospective study.
Transpl Int 2019 Aug;32(8):839-53. doi: 10.1111/tri.13423..
Keywords: Kidney Disease and Health, Mortality, Outcomes, Transplantation
Shen NT, Londono C, Gold S
Systematic review with meta-analysis on transplantation for alcohol-related liver disease: very low evidence of improved outcomes.
Under the hypothesis that, while liver transplantation for patients with alcohol-related liver disease (ALD) may improve mortality and relapse, findings will be limited by pre-specified causes of heterogeneity, researchers conducted a systematic review. Data from 10 studies comparing use of liver transplant in ALD to no-transplant was analyzed. Primary outcome of both was short- and long-term mortality and relapse. The results of the review indicate that liver transplantation for ALD patients suggests reduced mortality and relapse in heterogeneous, institution-specific populations. The authors note that, to understand efficacy of transplanting ALD, their research approach must change.
AHRQ-funded; HS000066.
Citation: Shen NT, Londono C, Gold S .
Systematic review with meta-analysis on transplantation for alcohol-related liver disease: very low evidence of improved outcomes.
World J Gastroenterol 2019 Apr 7;25(13):1628-39. doi: 10.3748/wjg.v25.i13.1628..
Keywords: Alcohol Use, Evidence-Based Practice, Mortality, Outcomes, Patient-Centered Outcomes Research, Surgery, Transplantation
Wey A, Gustafson SK, Salkowski N
Association of pretransplant and posttransplant program ratings with candidate mortality after listing.
The Scientific Registry of Transplant Recipients (SRTR) is responsible for understandable reporting of program metrics, including transplant rate, waitlist mortality, and posttransplant outcomes. SRTR developed five-tier systems for each metric to improve accessibility for the public. In this study, the researchers investigated the associations of the five-tier assignments at listing with all-cause candidate mortality after listing, for candidates listed July 12, 2011-June 16, 2014.
AHRQ-funded; HS024527.
Citation: Wey A, Gustafson SK, Salkowski N .
Association of pretransplant and posttransplant program ratings with candidate mortality after listing.
Am J Transplant 2019 Feb;19(2):399-406. doi: 10.1111/ajt.15032..
Keywords: Transplantation, Surgery, Mortality, Registries
Wey A, Salkowski N, Kasiske BL
Comparing Scientific Registry of Transplant Recipients posttransplant program-specific outcome ratings at listing with subsequent recipient outcomes after transplant.
To improve accessibility of program-specific reports to patients, the Scientific Registry of Transplant Recipients released a 5-tier system for categorizing 1-year posttransplant program evaluations. Whether this system predicts subsequent posttransplant outcomes at the time patients are waitlisted has been questioned. IN this study, researchers investigated the association of tier at listing and the corresponding continuous score used for tier assignment, which ranges from 0 (poor outcomes) to 1 (good outcomes), with eventual 1-year posttransplant graft survival.
AHRQ-funded; HS024527.
Citation: Wey A, Salkowski N, Kasiske BL .
Comparing Scientific Registry of Transplant Recipients posttransplant program-specific outcome ratings at listing with subsequent recipient outcomes after transplant.
Am J Transplant 2019 Feb;19(2):391-98. doi: 10.1111/ajt.15038..
Keywords: Transplantation, Surgery, Mortality, Registries, Adverse Events, Risk
Warsame F, Haugen CE, Ying H
Limited health literacy and adverse outcomes among kidney transplant candidates.
More than one-third of US adults have limited health literacy, putting them at risk of adverse clinical outcomes. In this study the investigators evaluated the prevalence of limited health literacy among 1578 adult kidney transplant (KT) candidates (May 2014-November 2017) and examined its association with listing for transplant and waitlist mortality in this pilot study. The investigators concluded that limited health literacy may be a salient mechanism in access to KT; programs to aid candidates with limited health literacy may improve outcomes and reduce disparities.
AHRQ-funded; HS024600.
Citation: Warsame F, Haugen CE, Ying H .
Limited health literacy and adverse outcomes among kidney transplant candidates.
Am J Transplant 2019 Feb;19(2):457-65. doi: 10.1111/ajt.14994..
Keywords: Health Literacy, Transplantation, Adverse Events, Patient-Centered Outcomes Research, Outcomes, Surgery, Mortality, Kidney Disease and Health
Holscher CM, Luo X, Massie AB
Better graft outcomes from offspring donor kidneys among living donor kidney transplant recipients in the United States.
This study used Scientific Registry of Transplant Recipients data 2001-2016 to evaluate death-censored graft failure (DCGF) and mortality for recipients of offspring versus nonoffspring living donor kidneys, using Cox regression models with interaction terms. The investigators found that kidneys from offspring donors provided lower graft failure and comparable mortality.
AHRQ-funded; HS024600.
Citation: Holscher CM, Luo X, Massie AB .
Better graft outcomes from offspring donor kidneys among living donor kidney transplant recipients in the United States.
Am J Transplant 2019 Jan;19(1):269-76. doi: 10.1111/ajt.15126..
Keywords: Transplantation, Surgery, Registries, Outcomes, Mortality, Adverse Events
Wey A, Valapour M, Skeans
Heart and lung organ offer acceptance practices of transplant programs are associated with waitlist mortality and organ yield.
Variation in heart and lung offer acceptance practices may affect numbers of transplanted organs and create variability in waitlist mortality. In this study, the authors examined offered acceptance ratios, or adjusted odds ratios, for heart and lung transplant programs individually and for all programs within donation service areas (DSAs) using offers from donors recovered July 1, 2016, and June 30, 2017.
AHRQ-funded; HS024527.
Citation: Wey A, Valapour M, Skeans .
Heart and lung organ offer acceptance practices of transplant programs are associated with waitlist mortality and organ yield.
Am J Transplant 2018 Aug;18(8):2061-67. doi: 10.1111/ajt.14885..
Keywords: Transplantation, Health Services Research (HSR), Mortality
Chang SH, Liu X, Carlsson NP
Reexamining the association of body mass index with overall survival outcomes after liver transplantation.
The purpose of this study is to identify the range of body mass index (BMI) at liver transplantation (LT) associated with the lowest risks of posttransplant mortality by Model of End Stage Liver Disease (MELD) category. It concluded that obesity in LT patients is not necessarily associated with higher posttransplantation mortality and highlighted the importance of the interaction between BMI and MELD category to determine their survival likelihood.
AHRQ-funded; HS022330.
Citation: Chang SH, Liu X, Carlsson NP .
Reexamining the association of body mass index with overall survival outcomes after liver transplantation.
Transplant Direct 2017 Jun 12;3(7):e172. doi: 10.1097/txd.0000000000000681.
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Keywords: Obesity, Transplantation, Mortality, Patient-Centered Outcomes Research, Outcomes
Rosenberg AS, Ruthazer R, Paulus JK
Survival analyses and prognosis of plasma-cell myeloma and plasmacytoma-like posttransplantation lymphoproliferative disorders.
Multiple myeloma/plasmacytoma-like posttransplantation lymphoproliferative disorder (PTLD-MM) is a rare complication of solid organ transplantation. Case series have shown variable outcomes, and survival data in the modern era are lacking. This study found that age at diagnosis, elevated creatinine, and white race were associated with inferior survival in patients with PTLD-MM.
AHRQ-funded; HS000060.
Citation: Rosenberg AS, Ruthazer R, Paulus JK .
Survival analyses and prognosis of plasma-cell myeloma and plasmacytoma-like posttransplantation lymphoproliferative disorders.
Clin Lymphoma Myeloma Leuk 2016 Dec;16(12):684-92.e3. doi: 10.1016/j.clml.2016.09.002.
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Keywords: Adverse Events, Cancer, Mortality, Transplantation, Outcomes
Dimou FM, Mehta HB, Adhikari D
The role of extended criteria donors in liver transplantation for nonalcoholic steatohepatitis.
The authors' objective was to determine the use of extended criteria donors (ECD) in patients with nonalcoholic steatohepatitis undergoing liver transplantation to stimulate a liver-specific predictive model for ECD use. They found that ECDs in nonalcoholic steatohepatitis were associated with similar overall survival but increased risk of graft failure. The authors concluded that creation of an easily calculated, liver-specific model similar to the Kidney Donor Profile Index may help risk stratify patients and improve organ allocation.
AHRQ-funded; HS022134.
Citation: Dimou FM, Mehta HB, Adhikari D .
The role of extended criteria donors in liver transplantation for nonalcoholic steatohepatitis.
Surgery 2016 Dec;160(6):1533-43. doi: 10.1016/j.surg.2016.06.051.
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Keywords: Transplantation, Patient-Centered Outcomes Research, Risk, Mortality, Outcomes
Donnelly JP, Locke JE, MacLennan PA
Inpatient mortality among solid organ transplant recipients hospitalized for sepsis and severe sepsis.
The researchers investigated the impact of solid organ transplant (SOT) on outcomes following sepsis. They found that among patients hospitalized for severe sepsis or sepsis, those with SOT had lower inpatient mortality than those without SOT.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Locke JE, MacLennan PA .
Inpatient mortality among solid organ transplant recipients hospitalized for sepsis and severe sepsis.
Clin Infect Dis 2016 Jul 15;63(2):186-94. doi: 10.1093/cid/ciw295.
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Keywords: Transplantation, Mortality, Sepsis, Hospitalization, Patient-Centered Outcomes Research
Donnelly JP, Wang HE, Locke JE
Hospital-onset Clostridium difficile infection among solid organ transplant recipients.
The researchers examined hospital-onset Clostridium difficile infection (CDI) from 2012 to 2014 among transplant recipients in the University HealthSystem Consortium, which includes academic medical center-affiliated hospitals in the United States. They found that factors associated with CDI among transplant recipients included transplant type, risk of mortality, comorbidities, and inpatient complications.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Wang HE, Locke JE .
Hospital-onset Clostridium difficile infection among solid organ transplant recipients.
Am J Transplant 2015 Nov;15(11):2970-7. doi: 10.1111/ajt.13491.
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Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Transplantation, Adverse Events, Mortality
Cauley RP, Potanos K, Fullington N
The effect of graft type on mortality in liver transplantation for hepatocellular carcinoma.
The researchers aimed to: (1) examine the risk of mortality in liver transplantation for hepatocellular carcinoma (HCC), (2) to establish if this risk is affected by partial graft use, and (3) to determine if this effect is mitigated by improved tumor-associated risk stratification. They found that the risk of mortality following LT does not differ by the type of graft used in recipients with favorable-risk HCC or those without HCC.
AHRQ-funded; HS019485.
Citation: Cauley RP, Potanos K, Fullington N .
The effect of graft type on mortality in liver transplantation for hepatocellular carcinoma.
Ann Transplant 2015 Mar 30;20:175-85. doi: 10.12659/aot.892613..
Keywords: Mortality, Cancer, Transplantation, Comparative Effectiveness, Outcomes