OPTN/SRTR 2022 Annual Data Report: Kidney.

Area of Science:

• Nephrology
• Transplantation Medicine
• Public Health

Background:

• The kidney transplantation field navigated the COVID-19 pandemic and evolving organ distribution in 2022.
• Record numbers of kidney transplants were performed, primarily driven by deceased donor kidney transplants (DDKTs).
• Persistent challenges include organ nonuse, disparities in living donor kidney transplant (LDKT) access, and delayed graft function.

Purpose of the Study:

• To analyze the key trends, successes, and challenges in kidney transplantation during 2022.
• To evaluate changes in pretransplant mortality, organ nonuse rates, and graft survival.
• To identify persistent disparities in access to DDKT and LDKT, particularly for pediatric recipients.

Main Methods:

• Analysis of national kidney transplant data from 2022.
• Comparison of transplant outcomes, including pretransplant mortality and graft survival, across different donor and recipient groups.
• Evaluation of organ nonuse rates based on donor characteristics and kidney donor profile index (KDPI).

Main Results:

• A record 26,309 kidney transplants were performed, with increased DDKTs; pretransplant mortality declined post-COVID-19.
• Organ nonuse rates increased, particularly for older donors and those with higher KDPI; LDKT access disparities persisted.
• Delayed graft function rose to 26.3% in adults; pediatric kidney transplants decreased, with ongoing racial disparities in LDKT.

Conclusions:

• While 2022 marked successes in kidney transplantation volume and survival, significant challenges in organ utilization and equitable access require continued attention.
• Improvements in long-term graft survival were observed, especially for LDKT recipients, highlighting its benefit.
• Addressing disparities in LDKT access for minority and publicly insured populations, as well as for pediatric candidates, remains critical.