A National Survey of Practice Patterns for Accepting Living Kidney Donors With Prior COVID-19.
A National Survey of Practice Patterns for Accepting Living Kidney Donors With Prior COVID-19.
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DOI：
10.1016/j.ekir.2021.05.003
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发表时间：
2021-08
影响因子：
6
通讯作者：
Sharfuddin AA
中科院分区：
文献类型：
--
作者：
Jan MY;Jawed AT;Barros N;Adebiyi O;Diez A;Fridell JA;Goggins WC;Yaqub MS;Anderson MD;Mujtaba MA;Taber TE;Mishler DP;Kumar V;Lentine KL;Sharfuddin AA
移植项目面临的一个关键问题是，是否、何时以及如何安全地接受从COVID-19感染中康复的活体肾脏供体（LKD）。这项研究的目的是了解目前的做法，接受这些LKD。我们调查了2020年9月3日至11月3日的美国移植计划。中心水平和参与者水平的反应进行了分析。来自115个独立中心的174名受访者做出了回应，占美国LKD项目的59%，占2019年LKD数量的72.4%和2020年LKD数量的72.5%（器官采购和移植网络-OPTN 2021）。总的来说，48.6%的答复中心收到了来自此类LKD的询问，而44.3%的中心目前正在评估。共有98名供体处于评估阶段，而27.8%的中心已批准42名此类供体继续进行供体。共有50.8%的参与者愿意等待3个月以上，91%的参与者愿意从感染开始到LD手术至少等待1个月。排除LD的最常见原因是COVID-19相关阿基的证据（59.8%），即使已消退，其次是COVID-19相关肺炎（28.7%）和住院治疗（21.3%）。接受此类供体最常见的问题是捐赠后的肾脏健康（59.2%），其次是传播给受体的风险（55.7%），供体围手术期肺部风险（41.4%）和未来供体肺部风险（29.9%）。接受COVID-19康复LKD的实践模式存在相当大的差异。需要持续的研究和建立共识来指导最佳实践，以确保接受此类供体的安全性。需要对此类供体进行长期密切随访。
A critical question facing transplant programs is whether, when, and how to safely accept living kidney donors (LKDs) who have recovered from COVID-19 infection. The purpose of the study is to understand current practices related to accepting these LKDs. We surveyed US transplant programs from 3 September through 3 November 2020. Center level and participant level responses were analyzed. A total of 174 respondents from 115 unique centers responded, representing 59% of US LKD programs and 72.4% of 2019 and 72.5% of 2020 LKD volume (Organ Procurement and Transplantation Network-OPTN 2021). In all, 48.6% of responding centers had received inquiries from such LKDs, whereas 44.3% were currently evaluating. A total of 98 donors were in the evaluation phase, whereas 27.8% centers had approved 42 such donors to proceed with donation. A total of 50.8% of participants preferred to wait >3 months, and 91% would wait at least 1 month from onset of infection to LD surgery. The most common reason to exclude LDs was evidence of COVID-19−related AKI (59.8%) even if resolved, followed by COVID-19−related pneumonia (28.7%) and hospitalization (21.3%). The most common concern in accepting such donors was kidney health postdonation (59.2%), followed by risk of transmission to the recipient (55.7%), donor perioperative pulmonary risk (41.4%), and donor pulmonary risk in the future (29.9%). Practice patterns for acceptance of COVID-19−recovered LKDs showed considerable variability. Ongoing research and consensus building are needed to guide optimal practices to ensure safety of accepting such donors. Long-term close follow-up of such donors is warranted.
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DOI：
10.7759/cureus.12075
发表时间：
2020-12-14
期刊：
Cureus
影响因子：
--
作者：
Bordes SJ;Montorfano L;West-Ortiz W;Valera R;Cracco A;Alonso M;Pinna AD;Ebaid S
通讯作者：
Ebaid S
影响因子：
6
作者：
Lentine, Krista L.;Vest, Luke S.;Axelrod, David A.
通讯作者：
Axelrod, David A.
影响因子：
15.8
作者：
Kolhe NV;Fluck RJ;Selby NM;Taal MW
通讯作者：
Taal MW
影响因子：
2.6
作者：
Salvalaggio, Paolo R.;Ferreira, Gustavo F.;Lentine, Krista L.
通讯作者：
Lentine, Krista L.
影响因子：
16.9
作者：
Massie, Allan B.;Holscher, Courtenay M.;Segev, Dorry L.
通讯作者：
Segev, Dorry L.