Paired Exchange Results Quarterly Report

®

Paired Exchange Results

Quarterly Report

As of March 31, 2018

Table of Contents Message From the Founder ..................................................................................................................................... 1 Transplants Facilitated ............................................................................................................................................. 2 Patient Referrals ..................................................................................................................................................... 3 Top Centers ............................................................................................................................................................ 3 NKR Graft Survival Advantage ................................................................................................................................. 4 Patient Survival Advantage ...................................................................................................................................... 4 Patients Waiting > 1 Year ........................................................................................................................................ 5 Patients Waiting > 1 Year by Center ........................................................................................................................ 5 Wait Time Distribution .............................................................................................................................................. 6 Cumulative Wait Time Distribution ........................................................................................................................... 6 Patients Waiting > 1 Year by cPRA ......................................................................................................................... 7 Pool Composition by cPRA ...................................................................................................................................... 8 Transplanted Patient Median Wait Time .................................................................................................................. 8 Transplanted Patients with cPRA > 80% ................................................................................................................. 9 Transplanted Patients by cPRA ............................................................................................................................... 9 Percent of Pool Matched and/or Transplanted ...................................................................................................... 10 New Pair Enrollments - Patients available for match runs ..................................................................................... 10 Pool Size - Unmatched patients by day ................................................................................................................ 11 Non-Directed Donor Registrations - via NKR Web Site ......................................................................................... 11 Non-Directed Donor Referrals ............................................................................................................................... 12 Chains Started ...................................................................................................................................................... 12 Chain & Loop Length Statistics .............................................................................................................................. 13 Great HLA Matches ................................................................................................................................................ 14 Compatible Pairs Transplanted .............................................................................................................................. 15 Failure Rates ......................................................................................................................................................... 16 Swap Failures by Primary Root Cause .................................................................................................................. 16 Failure Rate by Primary Root Cause .................................................................................................................... 17 Patients Deleted .................................................................................................................................................... 17 Pair Match Power is the Key to Understanding Wait Time .................................................................................... 18 NKR Wait Times ..................................................................................................................................................... 18 Summary Report - Broken Chains & Real Time Swap Failures ............................................................................ 19 Detail Report - Broken Chains & Real Time Swap Failures .................................................................................. 19 NKR Program Statistics ......................................................................................................................................... 20-21

Message From the Founder and CEO .................................................................................................................... 1Transplants Facilitated ............................................................................................................................................ 2Top Centers ............................................................................................................................................................. 2NKR Member Centers ............................................................................................................................................. 3Donor Care Network® Centers of Excellence .......................................................................................................... 4DASH Centers ......................................................................................................................................................... 4Remote Donor Centers ............................................................................................................................................ 5Partner Center Chain End Targets .......................................................................................................................... 5Top Center Liquidity Contributors ............................................................................................................................ 6Donor Contacts ........................................................................................................................................................ 6Non-Directed Donor Contacts ................................................................................................................................. 7Non-Directed Donor Referrals ................................................................................................................................. 7NKR Graft Survival Advantage ................................................................................................................................ 8NKR Graft Survival Advantage ................................................................................................................................ 8NKR Patient Survival Advantage ............................................................................................................................. 9NKR Patient Survival Advantage ............................................................................................................................. 9Pre-Workup Labs, 24-Hour Urine Jugs Shipped ................................................................................................... 10Pre-Workup Labs, Scripts Uploaded ..................................................................................................................... 10Pre-Workup Labs, Results Uploaded .....................................................................................................................11Patients Waiting > 1 Year by Quarter .....................................................................................................................11Patients Waiting > 1 Year by Center ...................................................................................................................... 12Transplanted Patient Median Wait Time ................................................................................................................ 12Wait Time Distribution ............................................................................................................................................ 13Pairs Waiting > 1 Year Due to Unfavorable Blood Type Combination ................................................................... 13Pairs Waiting > 1 Year Due to High cPRA ............................................................................................................ 14Unmatched Target Pairs ........................................................................................................................................ 15Pair Wait Time Analysis ......................................................................................................................................... 15Compatible Pairs Transplanted ............................................................................................................................. 16Pool Composition by cPRA .................................................................................................................................... 16Transplanted Patients with cPRA > 80% ............................................................................................................... 17Transplanted Patients by cPRA ............................................................................................................................. 17Pool Size ............................................................................................................................................................... 18New Exportable Pairs ............................................................................................................................................ 18Chains Started ....................................................................................................................................................... 19Chain and Loop Statistics ...................................................................................................................................... 19Great HLA Matches ............................................................................................................................................... 20Failure Rates ......................................................................................................................................................... 20Non-XM Swap Failures & TXP Surgeries Impacted .............................................................................................. 21XM Swap Failures & TXP Surgeries Impacted ...................................................................................................... 21Streamlined XMs Requested ................................................................................................................................. 22Bridge Donor Median Wait Times in Days ............................................................................................................. 22Bridge Donor Wait Times ....................................................................................................................................... 23Transplants per Bridge Donor................................................................................................................................ 23Summary Report - Broken Chains & Real Time Swap Failures ............................................................................ 24Detail Report - Broken Chains & Real Time Swap Failures .................................................................................. 24Advanced Donation Program (ADP) ...................................................................................................................... 25ADP Donations & Additional TXPs Facilitated ....................................................................................................... 26ADP Recipient Pool ............................................................................................................................................... 26ADP Recipients Outstanding vs. Overall Chains Started ...................................................................................... 27ADP Wait Time Analysis ........................................................................................................................................ 27 Program Statistics ............................................................................................................................................ 28-29

1

Message from the Founder and CEO We are pleased to report a 47% increase in transplants facilitated in the first quarter in 2018 with 147 transplants completed in Q1 2018, up from 100 transplants in Q1 2017. If we sustain this strong growth rate, we will pass the 3,000 transplant milestone by the end of the year. We are now able to provide 7 year graft and patient survival rates for the first time. The 7 year numbers, not only indicate an NKR graft and patient survival advantage, but this advantage appears to increase over time, indicating that NKR facilitated transplant outcomes are better over the longer term. We will be conducting research into why we are seeing this NKR graft

survival advantage even though the NKR patients transplanted are more highly sensitized and have more time on dialysis than the typical U.S. living donor transplants. Our private label automated donor intake platform (DASH) continues to expand with 16 centers now using the platform. A fully automated donor follow-up module has recently been completed and is in pilot at a major transplant center. We have also deployed the Donor Shield product that provides donor life insurance, disability insurance, lost wage reimbursement, travel & lodging reimbursement, donor legal support and coverage for uncovered complication costs, for all donors at a Donor Shield center. The Donor Shield product is currently being piloted at three Donor Care Network Centers of Excellence. We continue to see the pool of unmatched pairs shrink and wait times drop due to the impact of the Center Liquidity Contribution program and the Advanced Donation Program. The CLC program has reduced the number of NDDs and easy to match pairs being withheld from the NKR to facilitate internal swaps. The Advanced Donation Program is reducing wait times and pool size because it is increasing the number of NKR chain starts. These two factors are allowing us to match/transplant nearly all sensitized patients with a true cPRA of less than 99% in under six months while reducing the wait time for all pairs. It is the ongoing dedication and effort of our Member Centers that enable us to continue breaking records and achieving new milestones. Thank you for your support and keep up the great work. Sincerely,

Garet Hil Founder & CEO National Kidney Registry

2

Top CentersTransplants Last 12 Months

Transplants FacilitatedTransplants Facilitated

21

62

131

175

226

308 310

360

399

462

550

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Projected

Txp'

s

40 39 38

30 29

23 23

20 18 18

16 15 13

Top Centers Transplants Last 12 Months

3

NKR Member CentersAs of 3/31/2018

NKR Member Centers As of 3/31/2017

4

Donor Care Network® Centers of Excellence

DASH Centers

3 3

4

5

6 6

7

8 8 8

11 11 11 11 11

Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

Cornell

UCLA

Emory

Cleveland

UMinn

Georgetown

Brigham

Colorado

UCSD

Penn

Allegheny

2 2 2

4 4

7

8 8 8

9 9 9

10

11 11 11

13

16

Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

Loma Linda UH Cleveland Georgetown Avera Vidant Brigham Maine WalterReed Rush Cornell Allegheny Sharp StVincentIN MtSinai Maryland Emory

DASH Centers

5

Remote Donor Centers

Partner Center Chain End Targets

3 3 4

5

8 8 9

11

15 16

22

24

31

33 33

Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

Remote Donor Centers

Madison Vidant ASL Avera ChristHosp Indiana Loyola Stanford URMC CC Florida Sentara Baystate MayoMN New Mexico Penn St.VincentIN UCSD VCU UCSF Legacy Chicago Allegheny Jefferson Colorado Brigham Georgetown Sharp Mass Gen UMinn Cleveland Emory UCLA Cornell

Partner Center Chain End Targets

-6

-4 -4 -4

-12

0

-1

-3 -3

-5

-8

-5

1

-1

0 1

4 4

12

2 3

6 6

8

11

9

4

6 Target

* https://clc.kidneyregistry.org/WebForm1.aspx?ReportKeyPass=ag5Ghnf76Tghd765GFtre&NcsSummary=1&Sort=DefaultSort&Supress=1 Accessed 4/5/18 at 11:05 ET

0 0 33 0 21 100 67 200 600 14 8 0 767 114Decline Ratio

6

Top Center Liquidity ContributorsCLC Driven Match Offers - 3/17 - 3/18

Donor ContactsAcross All Donor Intake Platforms

Top Center Liquidity ContributorsCLC Driven Match Offers - 3/17 - 3/18

Across All Donor Intake Platforms

7

Non-Directed Donor ContactsVia NKR Donor Intake Platform

Non-Directed Donor ReferralsReferred to NKR Member Centers

Non-Directed Donor Contacts Via NKR Donor Intake Platform

975 739

1407 1164

843 1028

2104

5530

4449

2010 2011 2012 2013 2014 2015 2016 2017 2018 Annualized

41 110 93 96

2614

390

2013 2014 2015 2016 2017 2018 Annualized

Non-Directed Donor Referrals

Referred to NKR Member Centers

*2017: Donor intake system was re-engineered and the donor certification form was removed *2018: Pre-workup labs were implemented which screened out candidates not willing to complete 24 hour urine test

8

NKR Graft Survival AdvantageNKR Transplants vs. U.S. Living Donor Transplants (All Cause)

As of 9/30/2017

NKR Graft Survival AdvantageNKR Transplants vs. U.S. Living Donor Transplants (All Cause)

As of 9/30/2017

Provided courtesy of Johns Hopkins University School of Medicine, Department of Surgery *Not including CHIP patients; Kaplan-Meier GS Rates for Transplants Performed: 02/2008-06/2017 with follow-up through 09/30/2017

https://www.srtr.org/ SRTR data as of December, 2017

NKR Graft Survival Advantage NKR Transplants vs. U.S. Living Donor Transplants (All Cause)

As of 9/30/2017

98.6%

96.4%

93.2%

90.8%

98.3%

95.9%

92.7%

89.4%

1 Year 3 Year 5 Year 7 Year

NKR* (N=1673)

U.S. LD (OPTN Data)




As of 9/30/2017

98.6%

96.4%

93.2%

90.8%

98.3%

95.9%

92.7%

89.4%


NKR* (N=1673)

U.S. LD (OPTN Data)




As of 9/30/2017

98.6%

96.4%

93.2%

90.8%

98.3%

95.9%

92.7%

89.4%


NKR* (N=1673)

U.S. LD (OPTN Data)

0.3%

0.5% 0.5%

1.4%



As of 9/30/2017

9

NKR Patient Survival AdvantageNKR Transplants vs. U.S. Living Donor Transplants (All Cause)

As of 9/30/2017

NKR Patient Survival AdvantageNKR Transplants vs. U.S. Living Donor Transplants (All Cause)

As of 9/30/2017



NKR Patient Survival Advantage NKR Transplants vs. U.S. Living Donor Transplants (All Cause)

As of 9/30/2017

99.3%

97.6%

94.4%

91.70%

98.7%

96.3%

93.1%

89.20%

1 Year 3 Year 5 year 7 Year

NKR* (N=1673)

U.S. LD (OPTN Data)




As of 9/30/2017

99.3%

97.6%

94.4%

91.70%

98.7%

96.3%

93.1%

89.20%


NKR* (N=1673)

U.S. LD (OPTN Data)




As of 9/30/2017

99.3%

97.6%

94.4%

91.70%

98.7%

96.3%

93.1%

89.20%


NKR* (N=1673)

U.S. LD (OPTN Data)

0.6%

1.3% 1.3%

2.5%



As of 9/30/2017

10

44

136

223

308

362

317

376

Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18

Pre-Workup Labs 24-Hour Urine Jugs Shipped

3

53

108 119

215

202 197


Pre-Workup Labs Scripts Uploaded

Pre-Workup Labs24-Hour Urine Jugs Shipped

Pre-Workup LabsScripts Uploaded

11

Patients Waiting > 1 Year by QuarterAs of 3/31/2018

0

18

38

51

87

109

90


Pre-Workup Labs Results Uploaded

Patients Waiting > 1 Year by Quarter As of 3/31/2018

57 62

73

80 76 76

85 85 86 80

73

82 82

67 63

53 57

64 66 61

46

Q1 2013

Q2 2013

Q3 2013

Q4 2013

Q1 2014

Q2 2014

Q3 2014

Q4 2014

Q1 2015

Q2 2015

Q3 2015

Q4 2015

Q1 2016

Q2 2016

Q3 2016

Q4 2016

Q1 2017

Q2 2017

Q3 2017

Q4 2017

Q1 2018

Patie

nts

Pre-Workup LabsResults Uploaded

12

Patients Waiting > 1 Year by CenterAs of 3/31/2018

Transplanted Patient Median Wait TimeWait times of patients transplanted during prior 12 months

As of 3/31/2018

Patients Waiting > 1 Year by Center As of 3/31/2018

3 3 3 3 3 3 3

2 2 2 2

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

Patie

nts

Transplanted Patient Median Wait Time Wait times of patients transplanted during prior 12 months

As of 3/31/2018

4.7

3.9

2.5

3.0 3.0

2.3 2.1

2.2

1.8

2.1

2009 2010 2011 2012 2013 2014 2015 2016 2017 Q1 2018

Mon

ths

13

Wait Time DistributionTransplanted Pairs

Pairs waiting >1 yearDue to Unfavorable Blood Type Combination

5%

27%

42%

57% 49% 50%

61% 66% 61% 64% 66%

95% 47%

32%

20% 26% 22%

14% 13%

17% 17% 14%

0%

19% 12%

13% 14% 16% 13% 13%

10% 10% 12%

0% 7%

15% 10% 11% 12% 13% 8%

13% 10% 8%

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Q1-18

Wait Time Distribution Transplanted Pairs

366+ Days 181-365 Days 91-180 Days 0-90 Days

*As of 4/20/18

Pairs waiting >1 year Due to Unfavorable Blood Type Combination

# R Alias R ABO D ABO MHP cPRA4 R Age D Age PMPc Wait (Months) CLCu

1 PW64154 O A 0 49.7 53 48 7 22 -5140

2 R118DE O A 0 0.08 38 62 78 17 -18400

3 HIPIR O A 0 0 70 69 109 16 -41300

4 JZ0126 O B 0 0 49 52 4 15 -790

5 TB9421 O A 0 81.63 49 48 4 14 -5140

6 BSMCWA O A 0 0 67 66 113 14 -2630

7 2002087531 O AB 0 13.83 75 43 66 13 -2060

8 RFLCC07 O AB 0 0 52 44 109 13 -14040

*As of 4/20/18

Pairs waiting >1 year Due to Unfavorable Blood Type Combination

# R Alias R ABO D ABO MHP cPRA4 R Age D Age PMPc Wait (Months) CLCu

1 PW64154 O A 0 49.7 53 48 7 22 -5140

2 R118DE O A 0 0.08 38 62 78 17 -18400

3 HIPIR O A 0 0 70 69 109 16 -41300

4 JZ0126 O B 0 0 49 52 4 15 -790

5 TB9421 O A 0 81.63 49 48 4 14 -5140

6 BSMCWA O A 0 0 67 66 113 14 -2630

7 2002087531 O AB 0 13.83 75 43 66 13 -2060

8 RFLCC07 O AB 0 0 52 44 109 13 -14040

14

Pairs waiting >1 yearDue to High cPRA

*As of 4/20/18

23 J24548992N B O 50 99.95 39 37 0 33

24 R303348 B AB 0 99.95 58 41 0 31

25 BURCHD77 B B|B 0 99.95 40 44|38 0 30

26 UC06142609 O O 0 99.95 66 49 0 19

27 R5438 O O 0 99.95 63 36 0 19

28 JS966563 O O 0 99.92 38 52 0 15

29 MP14561160 O O 0 99.89 48 43 0 21

30 BC1946 O A 0 99.87 71 44 0 71

31 RS537425 B A 0 99.81 55 52 0 15

32 LCL2183933 O O|O 0 99.79 23 57|34 0 24

33 AD0043 O O 0 99.74 50 53 0 41

34 KHBHR A O 0 99.68 66 39 0 23

35 HAERROS76 O A 0 99.63 41 67 4 18

36 WDUR980 A AB 0 99.39 48 55 0 15

37 SMHCOL O A 0 98.52 22 55 0 29

38 BD02081975 B AB 0 97.17 42 50 0 13

# R Alias R ABO D ABO MHP cPRA4 R Age D Age PMPcWait

(Months)1 SMIT93 A A 0 100 24 50 0 662 STORB O A 0 100 61 66 0 643 MAB1402991 AB B|B|O 0 100 14 50|37|50 0 584 NL2157 O A 0 100 68 35 0 565 JFOR468 O B 0 100 63 64 0 396 FD809142R O A 0 100 16 48 0 297 CISJEN A A 25 100 33 35 0 268 JF61593 A O 0 100 50 35 0 259 R3148 A AB 0 100 39 34 0 2410 SS11376266 A A 10 100 63 39 0 2411 DM8150868 A A 0 100 30 28 0 2312 RUMOR A A 25 100 54 27 0 2213 EBKPR A O 0 100 36 26 0 2014 RG624929 O AB 0 100 33 51 0 1815 EGUE357 O O 0 100 62 36 0 1716 STESCA B B 6 100 44 41 0 1617 SCHNALRE O O 0 100 54 54 0 1518 DEKEDRE O O 0 100 47 35 0 1419 KM7491184 B O 0 100 43 48 0 1320 JJ1978 B O|O 0 99.97 39 47|36 0 5621 GM8784 B O 0 99.97 23 31 0 3122 J36760809G O O 50 99.97 37 27 0 2523 J24548992N B O 50 99.95 39 37 0 3324 R303348 B AB 0 99.95 58 41 0 3125 BURCHD77 B B|B 0 99.95 40 44|38 0 3026 UC06142609 O O 0 99.95 66 49 0 1927 R5438 O O 0 99.95 63 36 0 1928 JS966563 O O 0 99.92 38 52 0 1529 MP14561160 O O 0 99.89 48 43 0 2130 BC1946 O A 0 99.87 71 44 0 7131 RS537425 B A 0 99.81 55 52 0 1532 LCL2183933 O O|O 0 99.79 23 57|34 0 2433 AD0043 O O 0 99.74 50 53 0 4134 KHBHR A O 0 99.68 66 39 0 2335 HAERROS76 O A 0 99.63 41 67 4 1836 WDUR980 A AB 0 99.39 48 55 0 1537 SMHCOL O A 0 98.52 22 55 0 2938 BD02081975 B AB 0 97.17 42 50 0 13

Pairs waiting >1 year due to High cPRA

# R Alias R ABO D ABO MHP cPRA4 R Age D Age PMPcWait

(Months)1 SMIT93 A A 0 100 24 50 0 662 STORB O A 0 100 61 66 0 643 MAB1402991 AB B|B|O 0 100 14 50|37|50 0 584 NL2157 O A 0 100 68 35 0 565 JFOR468 O B 0 100 63 64 0 396 FD809142R O A 0 100 16 48 0 297 CISJEN A A 25 100 33 35 0 268 JF61593 A O 0 100 50 35 0 259 R3148 A AB 0 100 39 34 0 2410 SS11376266 A A 10 100 63 39 0 2411 DM8150868 A A 0 100 30 28 0 2312 RUMOR A A 25 100 54 27 0 2213 EBKPR A O 0 100 36 26 0 2014 RG624929 O AB 0 100 33 51 0 1815 EGUE357 O O 0 100 62 36 0 1716 STESCA B B 6 100 44 41 0 1617 SCHNALRE O O 0 100 54 54 0 1518 DEKEDRE O O 0 100 47 35 0 1419 KM7491184 B O 0 100 43 48 0 1320 JJ1978 B O|O 0 99.97 39 47|36 0 5621 GM8784 B O 0 99.97 23 31 0 3122 J36760809G O O 50 99.97 37 27 0 2523 J24548992N B O 50 99.95 39 37 0 3324 R303348 B AB 0 99.95 58 41 0 3125 BURCHD77 B B|B 0 99.95 40 44|38 0 3026 UC06142609 O O 0 99.95 66 49 0 1927 R5438 O O 0 99.95 63 36 0 1928 JS966563 O O 0 99.92 38 52 0 1529 MP14561160 O O 0 99.89 48 43 0 2130 BC1946 O A 0 99.87 71 44 0 7131 RS537425 B A 0 99.81 55 52 0 1532 LCL2183933 O O|O 0 99.79 23 57|34 0 2433 AD0043 O O 0 99.74 50 53 0 4134 KHBHR A O 0 99.68 66 39 0 2335 HAERROS76 O A 0 99.63 41 67 4 1836 WDUR980 A AB 0 99.39 48 55 0 1537 SMHCOL O A 0 98.52 22 55 0 2938 BD02081975 B AB 0 97.17 42 50 0 13

Pairs waiting >1 year due to High cPRA

15

Pair Wait Time Analysis

Unmatched Target PairsWaiting more than 12 Months

11

1

1

20 18

<98% 98%-99% 99% - 100% 100%

All CLC

CLC >= 0

CLC<0

Unmatched Target Pairs Waiting more than 12 Months

12

*As of 4/5, 3:40pm

11

1

1

20 18

<98% 98%-99% 99% - 100% 100%

All CLC

CLC >= 0

CLC<0

Unmatched Target Pairs Waiting more than 12 Months

12

*As of 4/5, 3:40pm Pair Wait Time Analysis

NKR

Ma

tch

ab

le P

airs

*As of 4/5, 3:55p m

79

43

28

8 11

1 1 0

All Wait Times > 3 Months > 6 Months

CLC <= 0

CLC > 0

Centers with

CLC <= 0

CLC > 0

Centers with

CLC <= 0

CLC > 0

Centers with Centers with

CLC <= 0

CLC > 0

> 12 Months

Pair Wait Time Analysis

NKR

Ma

tch

ab

le P

airs

*As of 4/5, 3:55p m

79

43

28

8 11

1 1 0

All Wait Times > 3 Months > 6 Months

CLC <= 0

CLC > 0

Centers with

CLC <= 0

CLC > 0

Centers with

CLC <= 0

CLC > 0

Centers with Centers with

CLC <= 0

CLC > 0

> 12 Months

16

Compatible Pairs Transplanted

Pool Composition by cPRAAs of 3/31/2018

3

11 13

27

53

40

1 4

7

15

21

9

2013 2014 2015 2016 2017 2018 Annualized

Compatible Pairs Transplanted

Compatible Pairs

Favorable Blood Type Combos

Pool Composition by cPRA As of 3/31/2018

35%

18% 7%

6%

11%

23%

cPRA

100%

95-99%

80-95%

50-80%

0-50%

0%

Pool Composition by cPRA As of 3/31/2018

35%

18% 7%

6%

11%

23%

cPRA

100%

95-99%

80-95%

50-80%

0-50%

0%

17

Transplanted Patients with cPRA > 80%

Transplanted Patients by cPRA

1

12

32

49

59

110

93

109

101 105

128

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Annualized

Paire

d Re

cipi

ent T

rans

plan

ts

Transplanted Patients with cPRA > 80%

Transplanted Patients by cPRA

0% 8% 12% 11% 15%

24% 14% 15% 11% 10% 13%

5%

11% 12% 17% 12%

12%

16% 15% 15% 13% 9%

0%

8%

15% 15% 15%

15% 15% 12%

13% 11% 12%

5%

13%

10%

17% 15%

15%

14% 16%

15% 20%

7%

90%

60% 51%

39% 44%

34% 41% 42% 46% 46%

59%

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

cPRA 95-100% 80-95% 50-80% 0-50% 0%

18

New Exportable Pairs

Pool SizeUnmatched Patients by Day

1/14/2012 – 3/31/2018

165

185

205

225

245

265

285

305 Ja

n-12

Fe

b-12

M

ar-1

2 Ap

r-12

M

ay-1

2 Ju

n-12

Ju

l-12

Aug-

12

Sep-

12

Oct

-12

Nov

-12

Dec

-12

Jan-

13

Feb-

13

Mar

-13

Apr-

13

May

-13

Jun-

13

Jul-1

3 Au

g-13

Se

p-13

O

ct-1

3 N

ov-1

3 D

ec-1

3 Ja

n-14

Fe

b-14

M

ar-1

4 Ap

r-14

M

ay-1

4 Ju

n-14

Ju

l-14

Aug-

14

Sep-

14

Oct

-14

Nov

-14

Dec

-14

Jan-

15

Feb-

15

Mar

-15

Apr-

15

May

-15

Jun-

15

Jul-1

5 Au

g-15

Se

p-15

O

ct-1

5 N

ov-1

5 D

ec-1

5 Ja

n-16

Fe

b-16

M

ar-1

6 Ap

r-16

M

ay-1

6 Ju

n-16

Ju

l-16

Aug-

16

Sep-

16

Oct

-16

Nov

-16

Dec

-16

Jan-

17

Feb-

17

Mar

-17

Apr-

17

May

-17

Jun-

17

Jul-1

7 Au

g-17

Se

p-17

O

ct-1

7 N

ov-1

7 D

ec-1

7 Ja

n-18

Fe

b-18

M

ar-1

8

Pool Size Unmatched Patients by Day

1/14/2012 - 3/31/2018

144

255 244

469 509

546 563

498

574

2010 2011 2012 2013 2014 2015 2016 2017 Q1-18 Annualized

New Exportable Pairs

19

Chains Started

Chain and Loop Statistics

8 6

12 13 15

12 10

17 15 14

12

19

14 13

18 19 22

15

22 22

28 29

34

44

53

64

Chains Started

Chain and Loop Statistics

**Updates as of 4/19/18

Category Count Mean Length Transplants

Ended 591 3.87 2287

Broken 24 4.12 99

Active 2 2.50 5

Chain Total 617 3.88 2394

Loops 105 2.33 245

Total 722 3.65 2636

20

57% 56%

64%

61%

66% 71%

67%

59% 63%

54%

57%

33%

2012 2013 2014 2015 2016 2017

Failure Rates MO Rate = 1-(XM/MO)

Swap Rate = 1-(TXP/XM)

Match Offer

Swap

Great HLA MatchesZero Mismatch

Failure Rates

Great HLA Matches Zero Mismatch

Count Recipient Center Swap # XP Date Donor ABO Recipient

ABO NKR cPRA Wait Time In Months

Donor Age ATOT

Recipient Age ATOT HLA Points

1 Penn 1227 2/14/2018 O O 7 3 58 26 100

2 Walter Reed 1203 2/8/2018 A AB 100 5 61 40 100

3 Maine 1157 1/3/2018 A A 100 9 54 52 100

4 Hartford 1191 1/3/2018 O O 0 9 46 59 100

5 Hopkins 1019 6/1/2017 A AB 0 2 40 55 100

6 Brigham 1026 5/24/2017 A A 95 2 58 33 100

7 ChristHosp 952 1/18/2017 A A 99 1 57 34 100

8 UMinn 928 11/8/2016 A A 100 4 66 12 100

9 Cincinnati 884 8/31/2016 A A 73 1 28 40 100

10 OSU 509 8/30/2016 A A 91 1 38 67 100

11 SCarolina 459 2/11/2016 A A 100 3 64 53 100

12 Madison 442 12/22/2015 A A 97 6 22 63 100

13 UMinn 440 11/19/2015 O O 100 5 23 20 100

14 UCLA 357 2/17/2015 A A 100 34 39 52 100

15 Emory 351 12/11/2014 A A 100 5 25 33 100

16 Hopkins 330 11/13/2014 A O 96 1 41 38 100

17 Loyola 324 8/5/2014 A A 100 1 37 55 100

18 Madison 674 1/9/2014 O A 99 5 29 33 100

19 Barnabas 182 10/3/2012 A A 92 4 51 50 100

20 Barnes 105 3/31/2011 A A 100 7 60 32 100

21 UCSF 58 6/15/2010 A A 100 6 47 58 100

57% 56%

64% 61% 66%

71% 69% 67%

59% 63%

54%

57%

33% 24%

2012 2013 2014 2015 2016 2017 2018

Failure Rates MO Rate = 1-(XM/MO)

Swap Rate = 1-(TXP/XM)

Match Offer Swap

21

Non-XM Swap Failures & TXP Surgeries Impacted

XM Swap Failures & TXP Surgeries Impacted

270

141

366

281

43 54

43

86 65

16

2014 2015 2016 2017 Q1-18

TXP Surgeries Impacted

Swap Failures

Non-XM Swap Failures & TXP Surgeries Impacted

122 124 129

158

135

16

30 33 35 32 33

4

2013 2014 2015 2016 2017 Q1-18

TXP Surgeries Impacted

Swap Failures

XM Swap Failures and TXP Surgeries Impacted

22

Streamlined XMs Requested

Bridge Donor Median Wait Times in Days

0

50

100

150

200

250

Apr-

13

May

-13

Jun-

13

Jul-1

3 Au

g-13

Se

p-13

O

ct-1

3 N

ov-1

3 De

c-13

Ja

n-14

Fe

b-14

M

ar-1

4 Ap

r-14

M

ay-1

4 Ju

n-14

Ju

l-14

Aug-

14

Sep-

14

Oct

-14

Nov

-14

Dec-

14

Jan-

15

Feb-

15

Mar

-15

Apr-

15

May

-15

Jun-

15

Jul-1

5 Au

g-15

Se

p-15

O

ct-1

5 N

ov-1

5 De

c-15

Ja

n-16

Fe

b-16

M

ar-1

6 Ap

r-16

M

ay-1

6 Ju

n-16

Ju

l-16

Aug-

16

Sep-

16

Oct

-16

Nov

-16

Dec-

16

Jan-

17

Feb-

17

Mar

-17

Apr-

17

May

-17

Jun-

17

Jul-1

7 Au

g-17

Se

p-17

O

ct-1

7 N

ov-1

7 De

c-17

Ja

n-18

Fe

b-18

M

ar-1

8

Fresh Blood FXM

Fresh Blood SXM

Fresh Blood EXM

Cryo SXM

Cryo EXM

Streamlined XMs Requested

59

41

14

19

14 12

6

13

8 10 9

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Q1-18

Bridge Donor Median Wait Times in Days

23

Bridge Donor Wait Times

Transplants per Bridge Donor

Bridge Donor Wait Times

Year Median Mean Max Min 2008 59 53 77 16 2009 41 59 187 3 2010 14 51 385 2 2011 19 23 68 4 2012 14 29 314 2 2013 12 20 92 2 2014 6 11 97 2 2015 13 26 175 2 2016 8 14 71 2 2017 10 16 114 2 Q1-18 9 12 44 2

2.3 2.1 2.1

2.3

4.2

8.3

6.3

6.8

5.9

5.3 5.2

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Q1-18

Transplants per Bridge Donor

24

Summary ReportBroken Chains & Real Time Swap Failures

Detail ReportBroken Chains & Real Time Swap Failures

Summary Report - Broken Chains & Real Time Swap Failures

Year # Bridge Donors

# Real Time Swap Failures

# Broken Chains

% Broken Per Year

2008 9 -- 3 33%

2009 29 1 2 7%

2010 61 -- 2 3%

2011 75 -- 0 0%

2012 54 -- 4 7%

2013 37 3 3 8%

2014 49 2 4 8%

2015 53 1 1 2%

2016 68 1 1 3%

2017 62 1 3 5%

2018 20 0 0 0%

Total 507 9 23

Detail Report - Broken Chains & Real Time Swap Failures # Reason Given Real Time Swap

Failures Broken Chains

Center Date

1 Job Issues/ long wait time/ many failed XMs Cornell 5/1/2008

2 No Reason Cornell 8/21/2008

3 No Reason CPMC 11/19/2008

4 Donor sick for swap then reneged later UTMC 6/9/2009

5 Medical UCSF 11/10/2009

6 Medical UCLA 3/16/2010

7 Second nuclear GFR test < 80 (79 down from 82) AGH 9/16/2010

8 No Reason MethodistTX 2/3/2012

9 No Reason UCSF 4/4/2012


11 Medical/Surgical Washington 11/5/2012

12 Aborted donor surgery CPMC 6/27/2013

13 Kidney declined by recipient surgeon RWJ/UPenn 7/23/2013

14 Recipient Medical Issue Porter 10/16/13

15 Kidney Declined by Recipient Surgeon Porter/Jefferson 1/9/14


17 Recipient Medical Issue Loop ChristHosp 3/11/14

18 Medical Hopkins 7/15/14

19 Medical Hopkins 10/9/14

20 Kidney Declined by Recipient Surgeon Tampa/Hopkins 7/7/15

21 Kidney Declined by Recipient Surgeon -- Porter/Aurora St Lukes 3/17/16

22 Donor reneged Maryland 8/8/16

23 Donor reneged SCarolina 1/10/17

24 Kidney Declined by Recipient Surgeon Indiana/UNC 9/27/2017

25 Donor Ruled Out- Medical Issue UMinn 8/23/2017

Total 9 23

25

Advanced Donation Program (ADP)Summary

As of 3/31/2018

Advanced Donation Program (ADP) Summary

As of 3/31/18

Type Cases Add'l TXPs Facilitated

80%+ cPRA TXPs

Facilitated

95%+ cPRA TXPs

Facilitated

Short-Term* 74 247 78 40

Voucher** 29 83 13 6

Total 103 331 91 46

*Short-Term– At time of advanced donation the intended ADP Recipient is in need of transplant.

**Voucher - At time of advanced donation the intended ADP Recipient is not in need and may never be in need of transplant.

26

ADP Donations & Additional TXPs Facilitated

ADP Recipient Pool

Ann

ualiz

ed

2 1 3 5 8 9

50

75

4 4 11 13

69

43

131

168

2011 2012 2013 2014 2015 2016 2017 2018 Annualized

ADP Donations

Additional TXPs

ADP Donations & Additional TXPs Facilitated

ADP Recipient Pool

2 2 1 1

2 4 4 4

2 0 0

2 2 2 3

2 4

3

6

2

6 6 5

8 7

6 4

7 9

7 7 7 7 8

9 10 10

9 7 7

11 9 9

11

15

20 18

19 19

22 21

27

31

38 39

41

44

48 Unmatched

All

*As of 4/5, 4:40pm

27

ADP Recipients Outstanding vs. Overall Chains Started

ADP Wait Time AnalysisAs of 3/31/18

1 2 1 3 2 3

39 45

36 46

55 63

83 87

160

192

2011 2012 2013 2014 2015 2016 2017 2018 Annualized

ADP Recipients not TXP'd

Chains Started

ADP Recipients Outstanding vs. Overall Chains Started

ADP Wait Time Analysis As of 3/31/18

63%

17%

14% 7%

<3 Months 3-6 Months 6-12 Months 1+ Year

28

Program StatisticsAs of 3/31/2018

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

1 Transplants Facilitated 21 62 131 175 226 308 310 360 399 462 147

2 Paired Transplants Facilitated 21 39 91 131 164 252 255 288 315 318 85

3 Chip Transplants Facilitated 0 23 40 44 62 56 55 72 84 144 62

4 Ending Unmatched Patient Pool 80 127 120 201 241 255 279 280 215 181 173

5 Cumulative Transplants 21 83 214 389 615 923 1233 1593 1992 2454 2601

6 Cumulative Paired Transplants 21 60 150 280 526 777 1030 1316 1630 1946 2031

7 Cumulative Chip Transplants 0 23 64 109 89 146 203 277 362 508 570

8 Cumulative Paired Patient Pool 101 210 334 590 805 1062 1351 1615 1877 2152 2243

9 Percent of Pool Transplanted (Paired Recipients) 21% 40% 64% 66% 71% 76% 79% 84% 89% 92% 92%

10 Enrolled Patient Mean Wait Time (years) 3.8 2.0 0.9 1.1 1.1 1.0 0.9 0.9 0.9 0.9 0.8

11 Transplanted Patient Mean Wait Time (months) 5.1 5.3 6.0 5.0 5.1 5.4 4.8 4.1 4.7 4.0 4.5

12 Transplanted Patient Median Wait Time (months) 5.3 5.3 3.9 2.5 3.0 3.0 2.3 2.1 2.2 1.8 1.8

13 Mean cPRA of Transplanted Patients 4.1% 25.9% 34.5% 40.3% 44.1% 54.0% 48.3% 48.9% 42.8% 41.9% 46.7%

14 Number of Transplants Completed by cPRA

15 100% 0 1 4 10 4 5 3 7 3 4 0

16 95-100% 0 4 12 10 29 68 41 47 39 41 19

17 80-95% 1 7 16 29 26 37 49 55 59 60 13

18 50-80% 0 5 19 27 33 46 48 42 53 49 18

19 0-50% 1 8 13 30 34 47 43 57 61 94 11

20 0% 19 37 67 69 100 105 126 152 184 214 86

21 Sub-total 21 62 131 175 226 308 310 360 399 462 147

22 Percent of Transplants Completed by cPRA

23 100% 0% 2% 3% 6% 2% 2% 1% 2% 1% 1% 0%

24 95-100% 0% 6% 9% 6% 13% 22% 13% 13% 10% 9% 13%

25 80-95% 5% 11% 12% 17% 12% 12% 16% 15% 15% 13% 9%

26 50-80% 0% 8% 15% 15% 15% 15% 15% 12% 13% 11% 12%

27 0-50% 5% 13% 10% 17% 15% 15% 14% 16% 15% 20% 7%

28 0% 90% 60% 51% 39% 44% 34% 41% 42% 46% 46% 59%

29 Sub-total 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

30 Number of Transplanted Patients with cPRA >80% 1 12 32 49 59 110 93 109 101 105 32

31 Percent of Transplanted Patients with cPRA >80% 5% 19% 24% 28% 26% 36% 30% 30% 26% 23% 22%

32 Number of Unmatched Patients by cPRA

33 100% 79 73 83 81 80 80 63 60

34 95-99% 73 73 61 61 53 37 32 32

35 80-95% 15 15 24 19 22 12 14 12

36 50-80% 14 11 14 13 25 13 8 10

37 0-50% 14 10 22 37 35 28 16 19

38 0% 50 59 51 68 65 45 48 40

39 Sub-total 245 241 255 279 280 215 181 173

40 Percent of Unmatched Patients by cPRA

41 100% 32% 30% 33% 29% 29% 37% 35% 35%

42 95-99% 30% 30% 24% 22% 19% 17% 18% 18%

43 80-95% 6% 6% 9% 7% 8% 6% 8% 7%

44 50-80% 6% 5% 5% 5% 9% 6% 4% 6%

45 0-50% 6% 4% 9% 13% 13% 13% 9% 11%

46 0% 20% 24% 20% 24% 23% 21% 27% 23%

47 Sub-total 100% 100% 100% 100% 100% 100% 100% 100%

48 Number of Transplants Completed by Wait Time

49 < 6 months 21 42 74 106 180 232 243 298 327 392 126

50 6-12 months 0 10 14 19 24 44 35 38 30 37 12

51 1-2 years 0 4 15 14 20 25 27 22 32 29 6

52 2+ years 0 0 2 2 2 7 5 2 10 4 3

53 Sub-total 21 56 105 141 226 308 310 360 399 462 147

54 Percent of Transplants Completed by Wait Time

55 < 6 months 100% 75.0% 70.5% 75.2% 79.6% 75.3% 78.4% 82.8% 82.0% 84.8% 85.7%

56 6-12 months 0.0% 17.9% 13.3% 13.5% 10.6% 14.3% 11.3% 10.6% 7.5% 8.0% 8.2%

57 1-2 years 0.0% 7.1% 14.3% 9.9% 8.8% 8.1% 8.7% 6.1% 8.0% 6.3% 4.1%

58 2+ years 0.0% 0.0% 1.9% 1.4% 0.9% 2.3% 1.6% 0.6% 2.5% 0.9% 2.0%

59 Sub-total 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

60 Total Chains Started 4 9 28 36 46 55 63 83 99 160 79

61 Total Loops Completed 0 3 2 3 12 24 17 15 7 15 0

62 Number of broken chains 3 2 2 0 4 3 4 1 2 2 0

63 Bridge Donors Held (2017 Annualized) 9 29 61 75 54 37 49 53 68 62 19

64 Percent of broken chains 33% 7% 3% 0% 7% 8% 8% 2% 3% 3% 0%

29

Program StatisticsAs of 3/31/2018

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018















15 100% 0 1 4 10 4 5 3 7 3 4 0

16 95-100% 0 4 12 10 29 68 41 47 39 41 19

17 80-95% 1 7 16 29 26 37 49 55 59 60 13

18 50-80% 0 5 19 27 33 46 48 42 53 49 18

19 0-50% 1 8 13 30 34 47 43 57 61 94 11

20 0% 19 37 67 69 100 105 126 152 184 214 86

21 Sub-total 21 62 131 175 226 308 310 360 399 462 147


23 100% 0% 2% 3% 6% 2% 2% 1% 2% 1% 1% 0%

24 95-100% 0% 6% 9% 6% 13% 22% 13% 13% 10% 9% 13%

25 80-95% 5% 11% 12% 17% 12% 12% 16% 15% 15% 13% 9%

26 50-80% 0% 8% 15% 15% 15% 15% 15% 12% 13% 11% 12%

27 0-50% 5% 13% 10% 17% 15% 15% 14% 16% 15% 20% 7%

28 0% 90% 60% 51% 39% 44% 34% 41% 42% 46% 46% 59%

29 Sub-total 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%




33 100% 79 73 83 81 80 80 63 60

34 95-99% 73 73 61 61 53 37 32 32

35 80-95% 15 15 24 19 22 12 14 12

36 50-80% 14 11 14 13 25 13 8 10

37 0-50% 14 10 22 37 35 28 16 19

38 0% 50 59 51 68 65 45 48 40

39 Sub-total 245 241 255 279 280 215 181 173


41 100% 32% 30% 33% 29% 29% 37% 35% 35%

42 95-99% 30% 30% 24% 22% 19% 17% 18% 18%

43 80-95% 6% 6% 9% 7% 8% 6% 8% 7%

44 50-80% 6% 5% 5% 5% 9% 6% 4% 6%

45 0-50% 6% 4% 9% 13% 13% 13% 9% 11%

46 0% 20% 24% 20% 24% 23% 21% 27% 23%

47 Sub-total 100% 100% 100% 100% 100% 100% 100% 100%


49 < 6 months 21 42 74 106 180 232 243 298 327 392 126

50 6-12 months 0 10 14 19 24 44 35 38 30 37 12

51 1-2 years 0 4 15 14 20 25 27 22 32 29 6

52 2+ years 0 0 2 2 2 7 5 2 10 4 3

53 Sub-total 21 56 105 141 226 308 310 360 399 462 147


55 < 6 months 100% 75.0% 70.5% 75.2% 79.6% 75.3% 78.4% 82.8% 82.0% 84.8% 85.7%

56 6-12 months 0.0% 17.9% 13.3% 13.5% 10.6% 14.3% 11.3% 10.6% 7.5% 8.0% 8.2%

57 1-2 years 0.0% 7.1% 14.3% 9.9% 8.8% 8.1% 8.7% 6.1% 8.0% 6.3% 4.1%

58 2+ years 0.0% 0.0% 1.9% 1.4% 0.9% 2.3% 1.6% 0.6% 2.5% 0.9% 2.0%

59 Sub-total 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%






2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018















15 100% 0 1 4 10 4 5 3 7 3 4 0

16 95-100% 0 4 12 10 29 68 41 47 39 41 19

17 80-95% 1 7 16 29 26 37 49 55 59 60 13

18 50-80% 0 5 19 27 33 46 48 42 53 49 18

19 0-50% 1 8 13 30 34 47 43 57 61 94 11

20 0% 19 37 67 69 100 105 126 152 184 214 86

21 Sub-total 21 62 131 175 226 308 310 360 399 462 147


23 100% 0% 2% 3% 6% 2% 2% 1% 2% 1% 1% 0%

24 95-100% 0% 6% 9% 6% 13% 22% 13% 13% 10% 9% 13%

25 80-95% 5% 11% 12% 17% 12% 12% 16% 15% 15% 13% 9%

26 50-80% 0% 8% 15% 15% 15% 15% 15% 12% 13% 11% 12%

27 0-50% 5% 13% 10% 17% 15% 15% 14% 16% 15% 20% 7%

28 0% 90% 60% 51% 39% 44% 34% 41% 42% 46% 46% 59%

29 Sub-total 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%




33 100% 79 73 83 81 80 80 63 60

34 95-99% 73 73 61 61 53 37 32 32

35 80-95% 15 15 24 19 22 12 14 12

36 50-80% 14 11 14 13 25 13 8 10

37 0-50% 14 10 22 37 35 28 16 19

38 0% 50 59 51 68 65 45 48 40

39 Sub-total 245 241 255 279 280 215 181 173


41 100% 32% 30% 33% 29% 29% 37% 35% 35%

42 95-99% 30% 30% 24% 22% 19% 17% 18% 18%

43 80-95% 6% 6% 9% 7% 8% 6% 8% 7%

44 50-80% 6% 5% 5% 5% 9% 6% 4% 6%

45 0-50% 6% 4% 9% 13% 13% 13% 9% 11%

46 0% 20% 24% 20% 24% 23% 21% 27% 23%

47 Sub-total 100% 100% 100% 100% 100% 100% 100% 100%


49 < 6 months 21 42 74 106 180 232 243 298 327 392 126

50 6-12 months 0 10 14 19 24 44 35 38 30 37 12

51 1-2 years 0 4 15 14 20 25 27 22 32 29 6

52 2+ years 0 0 2 2 2 7 5 2 10 4 3

53 Sub-total 21 56 105 141 226 308 310 360 399 462 147


55 < 6 months 100% 75.0% 70.5% 75.2% 79.6% 75.3% 78.4% 82.8% 82.0% 84.8% 85.7%

56 6-12 months 0.0% 17.9% 13.3% 13.5% 10.6% 14.3% 11.3% 10.6% 7.5% 8.0% 8.2%

57 1-2 years 0.0% 7.1% 14.3% 9.9% 8.8% 8.1% 8.7% 6.1% 8.0% 6.3% 4.1%

58 2+ years 0.0% 0.0% 1.9% 1.4% 0.9% 2.3% 1.6% 0.6% 2.5% 0.9% 2.0%

59 Sub-total 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%






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P.O. Box 460 • Babylon, NY 11702-0460

P.O. Box 460 · Babylon · NY 11702-0460

www.kidneyregistry.org

800-936-1627

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