■移植组织发布的中间器官等待时间在没有适当考虑审查时可能会有偏见,死亡,和竞争事件。这可能导致所有移植程序的等待时间过于乐观,因此,可能会欺骗等候名单上的病人,移植医生,和卫生保健政策制定者。
■应用竞争风险多州模型来计算移植概率和瑞士国家移植等待名单上的不良后果。
■WAIT(移植中的Waitlist分析)研究是一项回顾性队列研究,对2018年1月1日或以后在瑞士列出的所有移植候选人进行了观察,直到2023年12月31日。移植候选人被列入6个移植中心中的1个(巴塞尔,伯尔尼,日内瓦洛桑,圣加仑,和苏黎世)为心脏,肝脏,肺,肾,或胰腺和/或胰岛移植。在研究期间,共有4352名候选人被列入名单,其中709人(16.3%)因活体移植而被排除(肾脏项目691人,肝脏项目18人).
■等待器官移植。
■移植时间到了,死亡,或除名。使用竞争风险多状态模型与Aalen-Johansen估计器分析国家器官等待列表中的事件发生时间数据,以计算移植和不良结果的概率。将结果与仅接受移植和Kaplan-Meier方法的样本中位数进行比较,并审查了竞争事件。
■3643名移植候选人(2428[66.6%]男性;平均年龄,56[范围,0-79]年)纳入分析。心脏的中位移植时间(MTT)为0.91(95%CI,0.83-1.07)年,肾脏3.10(95%CI,2.57-3.77)年,肝脏1.32(95%CI,0.76-1.55)年,肺0.80(95%CI,0.37-1.12)年,胰腺和/或胰岛项目为1.62年(95%CI,0.91-2.17)。替代估计方法在不同程度上引入了偏差:与MTT相比,仅接受移植的人的样本中位数将等待时间低估了38%至61%,而Kaplan-Meier方法则低估了2%至12%。
■在这项针对瑞士移植候选人的队列研究中,MTT,移植概率为0.50时的持续时间被用作平均等待时间的量度.次优方法导致有偏差和过于乐观的等待时间估计;因此,应用适当的竞争风险方法来解决审查和竞争事件是至关重要的。
UNASSIGNED: Median organ waiting times published by transplant organizations may be biased when not appropriately accounting for censoring, death, and competing events. This can lead to overly optimistic waiting times for all transplant programs and, consequently, may deceive patients on the waiting list, transplant physicians, and health care policymakers.
UNASSIGNED: To apply competing-risk multistate models to calculate probabilities for transplantation and adverse outcomes on the Swiss national transplant waiting list.
UNASSIGNED: The WAIT (Waitlist Analysis in Transplantation) study was a retrospective cohort study of all transplant candidates in Switzerland listed from January 1, 2018, or later and observed until December 31, 2023. Transplant candidates were listed in 1 of the 6 transplant centers (Basel, Bern, Geneva, Lausanne, St Gallen, and Zurich) for heart, liver, lungs, kidney, or pancreas and/or islet transplant. A total of 4352 candidates were listed during the study period, of whom 709 (16.3%) were excluded due to living-donor transplant (691 in the kidney program and 18 in the liver program).
UNASSIGNED: Waiting for organ transplant.
UNASSIGNED: Time to transplantation, death, or delisting. Competing-risk multistate models were used to analyze time-to-event data from the national organ waiting list with the Aalen-Johansen estimator to compute probabilities for both transplant and adverse outcomes. Results were compared with the sample median among only those undergoing transplant and the Kaplan-Meier method with censoring of competing events.
UNASSIGNED: Data from 3643 transplant candidates (2428 [66.6%] male; median age, 56 [range, 0-79] years) were included in the analysis. The median time to transplantation (MTT) was 0.91 (95% CI, 0.83-1.07) years for heart, 3.10 (95% CI, 2.57-3.77) years for kidney, 1.32 (95% CI, 0.76-1.55) years for liver, 0.80 (95% CI, 0.37-1.12) years for lung, and 1.62 (95% CI, 0.91-2.17) years for pancreas and/or islet programs. Alternative estimation methods introduced bias to varying degrees: the sample median among only persons undergoing transplantation underestimated the waiting time by 38% to 61% and the Kaplan-Meier method by 2% to 12% compared with the MTT.
UNASSIGNED: In this cohort study of transplant candidates in Switzerland, the MTT, the duration at which the transplant probability is 0.50, was used as a measure of average waiting time. Suboptimal methods led to biased and overly optimistic waiting time estimations; thus, applying appropriate competing-risk methods to address censoring and competing events is crucial.