{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:53:56Z","timestamp":1789620836916,"version":"build-2803163510"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","funder":[{"DOI":"10.13039\/100009257","name":"ASN Foundation for Kidney Research","doi-asserted-by":"publisher","award":["Pre-Doctoral Fellowship Award"],"award-info":[{"award-number":["Pre-Doctoral Fellowship Award"]}],"id":[{"id":"10.13039\/100009257","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["K01HS024600"],"award-info":[{"award-number":["K01HS024600"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K01DK101677"],"award-info":[{"award-number":["K01DK101677"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K08DK092287"],"award-info":[{"award-number":["K08DK092287"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K01HL108832"],"award-info":[{"award-number":["K01HL108832"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"crossref","award":["K24AI144954"],"award-info":[{"award-number":["K24AI144954"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Patients with sickle cell disease\u2013associated kidney failure have high mortality, which might be lowered by kidney transplantation. However, because they show higher post-transplant mortality compared with patients with other kidney failure etiologies, kidney transplantation remains controversial in this population, potentially limiting their chance of receiving transplantation. We aimed to quantify the decrease in mortality associated with transplantation in this population and determine the chance of receiving transplantation with sickle cell disease as the cause of kidney failure as compared with other etiologies of kidney failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>Using a national registry, we studied all adults with kidney failure who began maintenance dialysis or were added to the kidney transplant waiting list in 1998\u20132017. To quantify the decrease in mortality associated with transplantation, we measured the absolute risk difference and hazard ratio for mortality in matched pairs of transplant recipients versus waitlisted candidates in the sickle cell and control groups. To compare the chance of receiving transplantation, we estimated hazard ratios for receiving transplantation in the sickle cell and control groups, treating death as a competing risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with their matched waitlisted candidates, 189 transplant recipients with sickle cell disease and 220,251 control recipients showed significantly lower mortality. The absolute risk difference at 10 years post-transplant was 20.3 (98.75% confidence interval, 0.9 to 39.8) and 19.8 (98.75% confidence interval, 19.2 to 20.4) percentage points in the sickle cell and control groups, respectively. The hazard ratio was also similar in the sickle cell (0.57; 95% confidence interval, 0.36 to 0.91) and control (0.54; 95% confidence interval, 0.53 to 0.55) groups (interaction\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.8). Nonetheless, the sickle cell group was less likely to receive transplantation than the controls (subdistribution hazard ratio, 0.73; 95% confidence interval, 0.61 to 0.87). Similar disparities were found among waitlisted candidates (subdistribution hazard ratio, 0.62; 95% confidence interval, 0.53 to 0.72).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with sickle cell disease\u2013associated kidney failure exhibited similar decreases in mortality associated with kidney transplantation as compared with those with other kidney failure etiologies. Nonetheless, the sickle cell population was less likely to receive transplantation, even after waitlist registration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.02720320","type":"journal-article","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T12:40:15Z","timestamp":1614256815000},"page":"407-414","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":20,"title":["Mortality and Access to Kidney Transplantation in Patients with Sickle Cell Disease\u2013Associated Kidney Failure"],"prefix":"10.2215","volume":"16","author":[{"given":"Sunjae","family":"Bae","sequence":"first","affiliation":[{"name":"Division of Transplantation, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland"},{"name":"Johns Hopkins Center for Health Equity, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan B.","family":"Massie","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Luo","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlton","family":"Haywood","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland"},{"name":"Sickle Cell Center for Adults, Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie M.","family":"Lanzkron","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland"},{"name":"Sickle Cell Center for Adults, Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan E.","family":"Grams","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"Division of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-4801","authenticated-orcid":false,"given":"Dorry L.","family":"Segev","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanjala S.","family":"Purnell","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"Johns Hopkins Center for Health Equity, Johns Hopkins University, Baltimore, 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Predicting survival after deceased donor kidney transplant by donor-recipient combination","volume":"19","author":"Bae","year":"2019","journal-title":"Am J Transplant"},{"key":"B8-20241015","doi-asserted-by":"crossref","first-page":"2310","DOI":"10.1111\/ajt.12830","article-title":"Survival benefit of primary deceased donor transplantation with high-KDPI kidneys","volume":"14","author":"Massie","year":"2014","journal-title":"Am J Transplant"},{"key":"B9-20241015","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1111\/ajt.12777","article-title":"Big data in organ transplantation: Registries and administrative claims [published correction appears in Am J Transplant 14: 2673, 2014 10.1111\/ajt.13038]","volume":"14","author":"Massie","year":"2014","journal-title":"Am J Transplant"},{"key":"B10-20241015","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1111\/j.1541-0420.2006.00527.x","article-title":"A sequential stratification method for estimating the effect of a time-dependent experimental treatment in observational studies","volume":"62","author":"Schaubel","year":"2006","journal-title":"Biometrics"},{"key":"B11-20241015","doi-asserted-by":"crossref","first-page":"2511","DOI":"10.1681\/ASN.2015030293","article-title":"Reduced racial disparity in kidney transplant outcomes in the United States from 1990 to 2012","volume":"27","author":"Purnell","year":"2016","journal-title":"J Am Soc Nephrol"},{"key":"B12-20241015","first-page":"620","article-title":"Association of race and age with survival among patients undergoing dialysis","volume":"306","author":"Kucirka","year":"2011","journal-title":"JAMA"},{"issue":"Suppl 1","key":"B13-20241015","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/ajt.14557","article-title":"OPTN\/SRTR 2016 annual data report: Kidney","volume":"18","author":"Hart","year":"2018","journal-title":"Am J Transplant"},{"key":"B14-20241015","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1001\/jama.2014.15063","article-title":"Association of sickle cell trait with chronic kidney disease and albuminuria in African Americans","volume":"312","author":"Naik","year":"2014","journal-title":"JAMA"},{"key":"B15-20241015","doi-asserted-by":"crossref","first-page":"2726","DOI":"10.1001\/jama.294.21.2726","article-title":"Deceased-donor characteristics and the survival benefit of kidney transplantation","volume":"294","author":"Merion","year":"2005","journal-title":"JAMA"},{"key":"B16-20241015","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1002\/sim.4780141406","article-title":"Transient effects in the Cox proportional hazards regression model","volume":"14","author":"Mauger","year":"1995","journal-title":"Stat Med"},{"key":"B17-20241015","doi-asserted-by":"crossref","first-page":"240","DOI":"10.7326\/M18-1570","article-title":"Renal transplantation and survival among patients with lupus nephritis: A cohort study","volume":"170","author":"Jorge","year":"2019","journal-title":"Ann Intern Med"},{"key":"B18-20241015","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","article-title":"A proportional hazards model for the subdistribution of a competing risk","volume":"94","author":"Fine","year":"1999","journal-title":"J Am Stat Assoc"},{"key":"B19-20241015","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1093\/aje\/kwp107","article-title":"Competing risk regression models for epidemiologic data","volume":"170","author":"Lau","year":"2009","journal-title":"Am J Epidemiol"},{"key":"B20-20241015","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1080\/01621459.1996.10476680","article-title":"Indicator and stratification methods for missing explanatory variables in multiple linear regression","volume":"91","author":"Jones","year":"1996","journal-title":"J Am Stat Assoc"},{"key":"B23-20241015","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1038\/ncpneph1008","article-title":"Sickle cell disease and the kidney","volume":"5","author":"Scheinman","year":"2009","journal-title":"Nat Clin Pract Nephrol"},{"key":"B24-20241015","doi-asserted-by":"crossref","first-page":"3191","DOI":"10.1111\/j.1600-6143.2012.04259.x","article-title":"Kidney, pancreas and liver allocation and distribution in the United States","volume":"12","author":"Smith","year":"2012","journal-title":"Am J Transplant"},{"key":"B25-20241015","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.humimm.2016.08.008","article-title":"Why do we have the kidney allocation system we have today? A history of the 2014 kidney allocation system","volume":"78","author":"Stegall","year":"2017","journal-title":"Hum Immunol"}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.02720320","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:43:26Z","timestamp":1786369406000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.02720320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,25]]},"references-count":23,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.2215\/cjn.02720320","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,25]]},"assertion":[{"value":"2020-03-03","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-21","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}