David D. Douglas, M.D., a gastroenterologist-hepatologist who is the Transplant Center director at Mayo Clinic's campus in Arizona and enterprise chair of Mayo Clinic's Transplant Center, answers questions about a statistical registry to guide decision-making.
What guidance is available for a physician who needs to refer a patient to a transplant center?
The Scientific Registry of Transplant Recipients (SRTR) is a critical resource for making this important referral decision. The registry contains a wealth of information about institutions' transplant rates and outcomes, and it compiles program-specific reports (PSRs) twice a year for the Department of Health and Human Services.
The choice of transplant center is critical because it allows the referral of your patient to a program where he or she is more likely to receive a transplant in a timely manner and also to have a better outcome after transplantation.
Which types of centers and organs are included in the registry?
The SRTR has PSRs for every transplant center in the United States. The database can be searched by program name or postal code and by type of organ transplant.
The types of organ transplant included in the database are:
What specific information is included in the PSRs about a center's capability for a particular type of organ transplant?
Each organ-transplant center listing has three main sections: program summary, waiting list information and transplant information. Within those sections are statistics on transplant rates, graft and patient survival, and much more.
How can physicians assess the likelihood of a patient's receiving a transplant at a specific center?
PSRs include transplant rates, which is the number of transplants per 100 patients listed per year at that center. Programs with higher transplant rates perform the procedures more frequently than programs with lower rates.
For example, according to the January 2018 PSR on liver transplant at Mayo Clinic in Jacksonville, Florida, the transplant rate is 158.9 — which is statistically better than the expected average of 85.5. At Mayo Clinic in Rochester, Minnesota, the kidney transplant rate is 33.7, which is statistically better than the expected rate of 25.
How can physicians assess the quality of care a patient is likely to receive while awaiting organ transplant?
PSRs report on waitlist mortality rates for every type of organ transplant at every institution. A low rate indicates strong clinical protocols to keep patients healthy while they await their transplants. For example, at Mayo's campus in Florida, the waitlist mortality rate for liver transplant in the January 2018 PSR is 11, which is statistically better than the expected mortality rate of 19.9.
What information about outcomes is available?
PSRs have statistics on graft and patient survival for all types of organ transplant at all institutions.
For example, according to the January 2018 PSR, 97.86 percent of patients had graft survival one year after heart transplant at Mayo's campus in Arizona — the only heart transplant program in the United States to have a statistically better-than expected outcome in that category. Three-year patient survival after liver transplant at Mayo's campus in Arizona is 91.02 percent, which is statistically better than expected.
What advantages does Mayo Clinic offer for patients referred for organ transplant?
Patients have the opportunity to list at other Mayo Clinic sites to increase their likelihood of finding a donor organ. All three Mayo Clinic sites use common clinical protocols for each organ. If a Mayo Clinic campus has more expertise in a specific area, patients might be referred to that site.
Mayo Clinic also uses an innovative process for accepting and transplanting organs. We are able to achieve high transplant rates while also achieving excellent patient and graft survival results. These strong outcomes are made possible by our integrated care teams working together to put the needs of our patients first.
I'm ready to make a referral. What's next?
To refer a patient or arrange a telephone consultation, contact the Referring Provider Office:
- Arizona campus: 866-629-6362 (toll-free), 8 a.m. to 5 p.m. Mountain time, Monday through Friday
- Florida campus: 800-634-1417 (toll-free), 8 a.m. to 5 p.m. Eastern time, Monday through Friday
- Minnesota campus: 800-533-1564 (toll-free), 24 hours a day, seven days a week
Please be prepared to specify the transplant service needed — bone marrow, hand, heart, kidney, pancreas, liver or lung transplant — so that the most appropriate person can assist you.