The evaluation of candidates for renal transplantation. The current practice of U.S. transplant centers.
The evaluation of candidates for renal transplantation. The current practice of U.S. transplant centers.
复制标题
肾移植候选者的评估。
作者：
Ramos El;B. Kasiske;S. Alexander;G. Danovitch;W. Harmon;L. Kahana;T. J. Kiresuk;J. Neylan
接受肾移植候选人的标准在美国各地各不相同。美国移植医师协会的患者护理和教育委员会对所有参与器官共享联合网络(UNOS)的美国中心进行了一项调查，内容是关于他们对成年肾移植候选人的评估。根据填写问卷的个人的专业，以及移植中心的类型(大学或私立)和中心的规模，对每个问题的回答进行了检查。问卷应答率为81%(147/182)。我们发现：(1)大学和较大的中心接受更多医学上复杂的患者；(2)83%的人注意到透析是移植后依从性的重要指标；(3)79%的人不要求身体肾受者术前输血；(4)66%的人没有设定移植的具体年龄上限；(5)56%的人排除了慢性活动性肝炎患者的乙肝抗原血症；(6)50%的人没有评估丙型肝炎抗体阳性患者的具体政策，54%的人排除了丙型肝炎抗体阳性献血者的使用，(7)15%的人对所有糖尿病患者进行了冠状动脉造影术。美国的移植中心对肾移植患者的评估有一种不同的方法，特别是在病毒性肝炎、心血管疾病和不依从方面。以大学为基础的中心和进行大量移植的中心接受更多医学上复杂的患者。
The criteria for acceptance of candidates for renal transplantation varies throughout the United States. The Patient Care and Education Committee of the American Society of Transplant Physicians conducted a survey of all U.S. centers that participate in the United Network for Organ Sharing (UNOS) concerning their evaluation of adult candidates for kidney transplantation. The response to each question was examined according to the specialty of the individual who filled out the questionnaire, as well as the type of transplant center (university or private) and the size of the center. The response rate to the survey was 81% (147/182). We found the following: (1) university-based and larger centers accepted more medically complicated patients; (2) 83% noted that attendance to dialysis was an important indicator of compliance after transplantation; (3) 79% did not require preoperative blood transfusions for cadaver kidney recipients; (4) 66% set no specific upper age limit for transplantation; (5) 56% excluded patients with chronic active hepatitis in the setting of hepatitis B antigenemia; (6) 50% had no specific policy for evaluating hepatitis C antibody-positive patients, while 54% excluded the use of hepatitis C antibody-positive donors, and (7) 15% obtained coronary angiography on all diabetic patients. U.S. transplant centers have a heterogeneous approach to the evaluation of patients for renal transplantation, particularly in the areas of viral hepatitis, cardiovascular disease, and noncompliance. University-based centers and centers that perform a larger number of transplants accept more medically complicated patients.