Experience after the evaluation of 700 potential donors for living donor liver transplantation in a single center
Experience after the evaluation of 700 potential donors for living donor liver transplantation in a single center
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DOI：
10.1002/lt.20223
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发表时间：
2004-09-01
影响因子：
4.6
通讯作者：
Broelsch, CE
中科院分区：
文献类型：
--
作者：
Valentín-Gamazo, C;Malagó, M;Broelsch, CE
充分的供体选择是活体肝移植（LDLT）的主要先决条件。很少有中心报告考虑或拒绝活体捐赠的潜在捐赠者的总数。从1998年4月到2003年7月，我们共进行了111例活体肝脏移植手术，对297例成人受体进行了622例潜在供体评估，对52例儿童受体进行了78例潜在供体评估。在成人组中，只有89名（14%）潜在捐赠者被认为是合适的，共有533名（86%）潜在捐赠者被拒绝。其中67%在最初筛选或在评估程序的第一和第二步中被排除。在所有案例中，有31%的捐赠者评估因受赠者问题而被取消。在儿科组，22名（28%）捐赠者被选中，其他56名（72%）被拒绝。整个评价过程的费用为每个捐助者4 589欧元(C)。对潜在活体捐赠者的评估是一个复杂而昂贵的过程。我们提出了对文献中报道的最大的成人潜在供体群体的评估结果。在我们的研究中，只有14%的潜在捐赠者被认为是合适的候选人。目前还没有确定谁应该承担评价所有被拒绝的捐助者的费用。总之，应尽一切努力制定有效的供体评估筛选方案，以节省肝移植项目的时间和资源。
Adequate selection of donors is a major prerequisite for living donor liver transplantation (LDLT). Few centers report on the entire number of potential donors considered or rejected for living donation. From April 1998 to July 2003, a total of 111 living donor liver transplantations were performed at our institution, with 622 potential donors for 297 adult recipients and 78 potential donors for 52 pediatric recipients evaluated. In the adult group, only 89 (14%) potential donors were considered suitable, with a total of 533 (86%) potential donors rejected. Of these, 67% were excluded either at initial screening or during the first and second steps of the evaluation procedure. In 31% of all cases, the evaluation of donors was canceled because of recipient issues. In the pediatric group, 22 (28%) donors were selected, with the other 56 (72%) rejected. Costs of the complete evaluation process accounted for 4,589 Euro (C) per donor. The evaluation of a potential living donor is a complex and expensive process. We present the results on the evaluation of the largest group of potential donors for adults reported in the literature. Only 14% of potential donors in our series were considered suitable candidates. It has not yet been established who should cover the expenses of the evaluation of all rejected donors. In conclusion, all efforts should be made in order to develop an effective screening protocol for the evaluation of donors with the aim of saving time and resources for a liver transplantation program.