Paired Exchange Results Quarterly Report

Transcription

1 Paired Exchange Results Quarterly Report As of September 3, 213

2 Table of Contents Message From the Founder... 1 Transplants Facilitated by Year... 2 Patient Referrals to NKR Member Centers... 2 New Pair Enrollments Per Month... 3 Pool Size - Unmatched Recipients... 3 Process Volume... 4 Match Conversion Rates... 4 Swap Failures by Primary Root Cause... 5 Transplants Impacted by Primary Root Cause... 5 Patients Waiting > 1 Year by cpra... 6 Patients Waiting > 1 Year by Center... 6 Patients Waiting > 1 Year... 7 Pool Composition by cpra Transplants by Wait Time... 8 Transplanted Patients with cpra > 8%... 9 Transplanted Patient Average Wait Time... 9 Enrolled Patient Average Wait Time... 1 Cumulative Pool Matched/Transplanted by Year... 1 Transplanted Patients by Year by cpra Average cpra of Transplanted Patients by Year Broken Chains by Year - Detail Summary of Broken Chains Top 1 Centers - % of Pairs Transplanted Through NKR Top 12 Centers - Pairs Active in NKR Top 1 Centers - Transplants in Last 12 Months Pair Match Power is the Key to Understanding Wait Time How is PMP Calculated NKR Wait Time Expectations Unmatched Pool - Excluding lightly sensitized O s with A/B/AB donors Unmatched Pool - Lightly sensitized O s with A/B/AB donors NKR Program Statistics

3 Message From the Founder Our third quarter results were strong and put us on track to facilitate 299 transplants for the year which is a 33% increase over the 226 transplants facilitated last year. Our third quarter performance brings us to 838 transplants since we started organizing swaps in 28. After investing aggressively in process changes to better screen patient and donor referrals, we are now providing higher quality referrals while continuing to deliver over a thousand referrals to our Member Centers annually. This helps folks who are in need of NKR s paired exchange services and provides growth opportunities for our Member Centers. In the third quarter, we demonstrated continued success finding matches for the hardest to match patients. As a result, we expect to nearly double the number of patients transplanted this year who have cpra scores above 8%. Additionally, 21% of our transplanted patients in 213 had cpra scores > 95%. This capability to find matches for the most highly sensitized patients has also allowed us to slow the growth of our unmatched pool which is having the direct effect of reducing wait times. We continued our focus on identifying root causes and corrective actions for swap failures. We improved our conversion rate from match offers to cross matching as a direct result of increased utilization of the donor preselect function. We also witnessed significant improvement in cross match accuracy which was offset by more swap failures caused by donors who were not ready for surgery. Reducing swap failures will continue to be a priority for us as member centers fine tune their internal processes to eliminate preventable swap failures, thereby improving the reliability of our service to patients in need of a transplant. None of this success would be possible without the effort and dedication of the medical professionals at our Member Centers. Thank you - and keep up the great work. Sincerely Garet Hil Founder & CEO National Kidney Registry 1

4 Transplants Facilitated by Year Forecast 35 Patient Referrals to NKR Member Centers Referrals Aug Sep Oct Nov Dec Jan 12 Feb Mar Apr May Jun Jul 12 Aug Sep Oct Nov Dec Jan 13 Feb Mar Apr May Jun Jul 13 Aug Sep 2

5 3 New Pair Enrollments Per Month Jan 1 Feb 1 Mar 1 Apr 1 May 1 Jun 1 Jul 1 Aug 1 Sep 1 Oct 1 Nov 1 Dec 1 Jan 11 Feb 11 Mar 11 Apr 11 May 11 Jun 11 Jul 11 Aug 11 Sep 11 Oct 11 Nov 11 Dec 11 Jan 12 Feb 12 Mar 12 Apr 12 May 12 Jun 12 Jul 12 Aug 12 Sep 12 Oct 12 Nov 12 Dec 12 Jan 13 Feb 13 Mar 13 Apr 13 May 13 Jun 13 Jul 13 Aug 13 Sep 13 Pairs

6 Process Volume Individual Matches Offered XMS Requested Transplants Facilitated Actual 213 Q1 Annualized 213 Q2 Annualized 213 Q3 Annualized Match Conversion Rates 6% Individual Offers to XMS XMS to Transplants 5% 43% 49% 45% 52% 4% 3% 33% 26% 31% 26% 2% 1% % 212 Full Year 213 Q1 213 Q2 213 Q3 4

7 Swap Failures by Primary Root Cause Q Donor Not Ready Unacceptable XM Late Stage Donor Decline Recipient Not Ready 5 45 Transplants Impacted by Primary Root Cause Q Donor Not Ready Unacceptable XM Late Stage Donor Decline Recipient Not Ready 5

8 8 Patients Waiting > 1 Year by Center As of 9/3/

9 Patients Waiting > 1 Year As of 9/3/ Q1 213 Q2 213 Q

10 8

11 Transplanted Patients with cpra > 8% YTD 213 Annualized Transplanted Patient Average Wait Time The average of the actual wait times of patients transplanted during the year Months Sep 3th 213 9

12 Enrolled Patient Average Wait Time Ending unmatched patient pool/annual transplant run rate Years Sep 3th 213 Cumulative Pool Matched/Transplanted by Year 9% 84% 8% Percentage of pool matched/transplanted 7% 6% 5% 4% 3% 2% 21% 4% 64% 66% 71% 1% 1 % Sep 3th 213

13 Average cpra of Transplanted Patients by Year 6% 53.4% 5% 4% 34.5% 4.3% 44.1% 3% 25.9% 2% 1% 4.1% % Sep 3th

14 Broken Chains by Year - Detail Year # Bridge Donors # Broken Chains % Broken Per Year % % % % % 213 Est % Total Bridge Donors Summary of Broken Chains # Reason Given Center Date 1 Job Issues/ long wait time/ many failed XMs Cornell 5/1/28 2 No Reason Cornell 8/21/28 3 No Reason CPMC 11/19/28 4 Two cancelled swaps/ long wait time UTMC 6/9/29 5 Medical UCSF 11/1/29 6 Medical UCLA 3/16/21 7 Second nuclear GFR test < 8 (79 down from 82) AGH 9/16/21 8 No Reason MethodistTX 2/3/212 9 No Reason UCSF 4/4/212 1 Medical UCLA 6/28/ Medical/Surgical Washington 11/5/ Real Time Swap Failure Aborted donor surgery CPMC 6/27/ Real Time Swap Failure Kidney declined by recipient surgeon RWJ/UPenn 7/23/213 12

15 94% 93% 93% Top 1 Centers % of Pairs Transplanted Through NKR 92% 9% 88% 88% 88% 88% 86% 86% 84% 84% 84% 83% 83% 82% 8% 78% Cornell MassGen Emory UTMC Porter AH CPMC Barnabas Cleveland Clinic UCLA UMaryland Top 12 Centers Pairs Active in NKR UCLA Madison UCSF UCincinnati Methodist TX Barnabas Starzl Loyola Cornell Sharp Mt Sinai Allegheny 13

16 Top 1 Centers Transplants in Last 12 Months Barnabas Madison UCSF Cornell UCLA Maryland Cleveland Clinic Emory CPMC Upenn 14

17 Pair Match Power is the Key to Understanding Wait Time Pair Match Power (a.k.a. PMP) is the most accurate predictor of paired exchange wait time and should be used by patients and clinicians to develop individual matching strategies for all pairs enrolling in the NKR program How is PMP Calculated 5 out of 1 viable exportable donors match this recipient Recipient Paired Donor 4 out of 2 recipients match this donor Recipient Donor Match Power Match Power 5/1 = 5% 4/2 = 2% PMP = (5% x 2% x 1,) + (5% x 1,) = 15 NKR Wait Time Expectations Group Match Descriptions Pair s PMPc Score Pair s ABO Combo Wait Time Range In Months Center Response A Easy Match >3 Easy 6 Watch for match offer & get pair ready for surgery B Hard Match 1 3 Easy 12 Implement advanced matching strategies C Very Hard Match <1 Easy Unknown Get lab director involved D Hard Match N/A Hard * 18 Relax preferences & work up additional paired donors * Lightly Sensitized (<8% NKR cpra) recipients with A/B/AB paired donors 15

18 Unmatched Pool Excluding lightly sensitized O s with A/B/AB donors PMPc over Wait Time 5 A B PMPc C Wait Time Unmatched Pool Lightly sensitized O s with A/B/AB donors PMPc over Wait Time PMPc 8 6 D Wait Time 16

19 NKR Program Statistics Sep 3th Transplants Facilitated Paired Transplants Facilitated Chip Transplants Facilitated Ending Unmatched Patient Pool Cumulative Transplants Cumulative Paired Transplants Cumulative Chip Transplants Cumulative Paired Patient Pool Percent of Pool Transplanted (Paired Recipients) 21% 4% 64% 66% 71% 84% 1 Enrolled Patient Average Wait Time (years) Transplanted Patient Average Wait Time(months) Average cpra of Transplanted Patients 4.1% 25.9% 34.5% 4.3% 44.1% 53.4% 13 Number of Transplants Completed by cpra 14 1% % % % % % Sub-total Percent of Transplants Completed by cpra 22 1% % 2% 3% 6% 2% 1% % % 6% 9% 6% 13% 2% % 5% 11% 12% 17% 12% 12% % % 8% 15% 15% 15% 17% 26-5% 5% 13% 1% 17% 15% 16% 27 % 9% 6% 51% 39% 44% 34% 28 Sub-total 1% 1% 1% 1% 1% 1% 29 Number of Transplanted Patients with cpra >8% Percent of Transplanted Patients with cpra >8% 5% 19% 24% 28% 26% 33% 31 Number of Unmatched Patients by cpra (9/3/213) 32 1% % % % % % Sub-total Percent of Unmatched Patients by cpra (9/3/213) 4 1% 3% 29% % 3% 29% % 6% 8% % 5% 5% 44-5% 4% 9% 45 % 24% 2% 46 Sub-total 1% 1% 47 Number of Transplants Completed by Wait Time (9/3/213) 48 < 6 months months years years Sub-total Percent of Transplants Completed by Wait Time (9/3/213) 54 < 6 months 1.% 75.% 7.5% 75.2% 79.6% 73.5% months.% 17.9% 13.3% 13.5% 1.6% 16.6% years.% 7.1% 14.3% 9.9% 8.8% 7.6% years.%.% 1.9% 1.4%.9% 2.2% 58 Sub-total 1% 1% 1% 1% 1% 1% 59 Total Chains Started Total Loops Completed Number of broken chains Bridge Donors Held (213 estimated) Percent of broken chains 33% 7% 3% % 7% 3% 17

20 P.O. Box 46 Babylon NY