Living Organ Donor Health Care Priorities During the COVID-19 Pandemic.
Living Organ Donor Health Care Priorities During the COVID-19 Pandemic.
复制标题
在COVID-19-19大流行期间，活器官捐赠者的卫生保健优先事项。
DOI：
10.1016/j.ekir.2021.01.031
复制
发表时间：
2021-04
影响因子：
6
通讯作者：
Harhay MN
中科院分区：
文献类型：
--
作者：
Zaidi H;Klassen AC;Fleetwood J;Lentine KL;Reese PP;Mittelman M;Bertha R;Harhay MN
在2019冠状病毒病（COVID-19）大流行开始时，美国的大多数移植项目暂停了活体肾脏和肝脏移植手术。[1]尽管许多项目已经恢复了这些程序，但从2020年3月13日（COVID-19紧急声明的日期）到2020年6月1日，活体肾脏和肝脏移植的累计数量比2019年同期的累计数量低了近70%。2在最近一项关于移植计划的全国性调查研究中，56%的受访者认为，供体和移植候选人的担忧是大流行期间活体供体移植的重大障碍。3尽管移植项目的重点是采取措施降低COVID-19对活体捐赠者的传播风险（例如，通过使用远程医疗进行临床评估和要求捐赠前自我隔离），但需要更多地了解捐赠者在大流行期间对捐赠的担忧和态度，以改善共同决策和以捐赠者为中心的护理流程。由于COVID-19大流行，美国和世界各地的移植计划继续面临动态条件，本研究的目标是阐明在线支持小组（补充方法）的既往和潜在器官捐献者成员对首选信息来源的看法，减轻捐赠相关风险的优先事项，以及在大流行期间经历的过度健康相关和其他负担。我们还评估了捐赠者的观点是否因当地COVID-19负担、与受体的关系和捐赠器官类型而不同。在大约550名积极支持小组成员中，157人（28%）对调查研究做出了回应，其中148人符合纳入标准（补充方法）。大多数受访者是既往或潜在的肾脏供体（n= 111，75%）。该队列为94%的非西班牙裔白色和91%的女性。与潜在供体相比，既往供体年龄较大（51-70岁：13% vs. 33%，P= 0.04），而其他人口统计学特征相似（表1）。受访者居住在美国40个州和哥伦比亚特区。受访者认为私人医生是他们最重要的信息来源（重要性中位数90 [四分位数间距{IQR} 72-100]），其次是移植计划（86 [IQR 65.5-100]）和官方网站（79 [IQR 58-92]）。社交媒体是最不重要的信息来源（26 [IQR 11-54]）。信息来源的评级没有因受访者与移植受者的关系、捐赠器官类型、以前或潜在的捐赠者身份或调查回复日期所在州的COVID-19病例负担而有所不同。
At the onset of the coronavirus disease 2019 (COVID-19) pandemic, the majority of transplant programs in the United States suspended living donor kidney and liver transplant surgeries. 1 Although many programs have since resumed these procedures, the cumulative number of living donor kidney and liver transplants between March 13, 2020 (the date of the COVID-19 emergency declaration) and June 1, 2020 was almost 70% lower than the cumulative number over the same timeframe in 2019. 2 In a recent national survey study of transplant programs, 56% of respondents cited donor and transplant candidate concerns as a substantial barrier to living donor transplant during the pandemic. 3 Although transplant programs have focused on steps to mitigate COVID-19 transmission risk to living donors (eg, by using telemedicine for clinical evaluations and requiring predonation selfquarantine), 3, 4 more knowledge is needed on donor concerns and attitudes about donation during the pandemic to improve processes of shared decisionmaking and donor-centered care. As transplant programs in the United States and across the world continue to face dynamic conditions due to the COVID-19 pandemic, the goal of this study was to elucidate the perspectives of previous and prospective organ donor members of an online support group (Supplementary Methods) about preferred information sources, priorities for mitigating donationrelated risks, and excess health-related and other burdens experienced during the pandemic. We also assessed whether donor perspectives differed by local COVID-19 burden, relationship to recipient, and donor organ type.Among approximately 550 active support group members, 157 individuals responded to the survey study (28%), of which 148 met the inclusion criteria (Supplementary Methods). The majority of respondents were previous or prospective kidney donors (n= 111, 75%). The cohort was 94% non-Hispanic white and 91% female. Compared with prospective donors, previous donors were older (51–70 years of age: 13% vs. 33%, P= 0.04), whereas other demographics were similar (Table 1). Respondents resided in 40 US states and the District of Columbia. Respondents rated personal doctors as their most important information source (median importance 90 [interquartile range {IQR} 72–100]), followed by transplant programs (86 [IQR 65.5–100]) and official websites (79 [IQR 58–92]). Social media was the least important source of information (26 [IQR 11–54]). Ratings on sources of information did not differ by respondents' relationships with transplant recipients, donor organ type, previous or prospective donor status, or COVID-19 case burden in their state on the date of survey response.
登录
查看更多内容
影响因子：
2.9
作者：
Dew, Mary Amanda;Jacobs, Cheryl L.
通讯作者：
Jacobs, Cheryl L.
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：
2.1
作者：
Mittelman, Michael;Bertha, Rebecca;Sutha, Ken
通讯作者：
Sutha, Ken
影响因子：
8.8
作者：
Boyarsky, Brian J.;Po-Yu Chiang, Teresa;Garonzik-Wang, Jacqueline M.
通讯作者：
Garonzik-Wang, Jacqueline M.