Measuring Living Kidney Transplantation at Renal Transplant Centers

描述(由申请人提供)： 彼得·P·里斯博士是宾夕法尼亚大学医学院肾科的国家研究服务奖获得者，他正在申请K-23患者导向研究职业发展奖，以获得更多的经验和技能，成为一名专注于移植的独立研究员。这份提案概述了一项为期5年的多学科培训计划，由宾夕法尼亚大学临床流行病学和生物统计中心临床流行病学部门主任哈罗德·I·费尔德曼博士进行研究、课程和指导。里斯博士将继续学习流行病学、生物统计学、卫生政策和医学伦理学方面的课程，这些课程与他提出的K-23项目直接相关，这将使他为领导未来与肾移植相关的独立研究项目做好准备。 美国终末期肾病(ESRD)的发病率继续攀升，给患者带来了毁灭性的后果，包括增加了心血管死亡的风险和慢性透析的负担。不断增长的终末期肾病人群加剧了对肾移植的需求，与慢性透析相比，肾移植被证明可以降低死亡率并提高生活质量。鉴于已故供者肾脏的供应有限，移植专业人士越来越关注活体肾脏移植。对于移植候选者来说，最大限度地利用这一重要资源可以大大减轻ESRD的负担。 不同肾移植中心活体肾移植的数量存在巨大且无法解释的差异。来自器官共享联合网络的全面移植记录为阐明这种变异背后的因素提供了宝贵的机会。通过拟议的项目，里斯博士将测量移植中心内和移植中心之间的活体肾移植数量，并确定与活体肾移植数量变化相关的中心属性。了解移植中心如何优化或限制患者获得活体肾移植的机会，是制定战略以扩大整体移植机会的关键进展。

DESCRIPTION (provided by applicant): Dr. Peter P. Reese, a National Research Service Award Fellow in the Renal Division at the University of Pennsylvania School of Medicine, is applying for a K-23 Patient Oriented Research Career Development Award to acquire further experience and skills for an academic career as an independent investigator focused on transplantation. This proposal outlines a 5-year multi-disciplinary training program consisting of research, coursework, and mentoring by Dr. Harold I. Feldman, Director of the Clinical Epidemology Unit at Penn's Center for Clinical Epidemology and Biostatistics. Dr. Reese will pursue coursework in epidemiology, biostatistics, health policy and medical ethics which pertain directly to his proposed K-23 project, and which will prepare him to lead future independent research programs related to renal transplantation. The prevalence of end-stage renal disease (ESRD) in the United States (US) continues to climb, with devastating consequences for patients including an elevated risk of cardiovascular death and the burden of chronic dialysis. The growing ESRD population has intensified the demand for kidney transplantation, which has been shown to reduce mortality and improve quality of life compared to chronic dialysis. Given a limited supply of deceased donor kidneys, transplant professionals have increasingly focused attention on living kidney transplantation. Maximizing this vital resource for transplant candidates could substantially reduce the burdens of ESRD. Large and unexplained variation exists in the magnitude of living kidney transplantation across renal transplant centers. Comprehensive transplantation records from the United Network of Organ Sharing offer a valuable opportunity to elucidate the factors underlying this variation. Through the proposed project, Dr. Reese will measure magnitude of living kidney transplantation within and across transplant centers, and identify center attributes associated with variation in the magnitude of living kidney transplantation. Understanding how transplant centers optimize or limit their patients' opportunities to obtain a live donor kidney transplant represents a crucial advance in developing strategies to expand access to transplantation overall.