OPTN/SRTR 2013 Annual Data Report: kidney
OPTN/SRTR 2013 Annual Data Report: kidney
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DOI：
10.1111/ajt.13195
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发表时间：
2015-01-01
影响因子：
8.8
通讯作者：
Kasiske, B. L.
中科院分区：
文献类型：
--
作者：
Matas, A. J.;Smith, J. M.;Kasiske, B. L.
预计将于2014年底实施的新的肾脏分配系统将使用肾脏供体档案指数（KDPI）以百分比（0%-100%）对供体进行表征。预期移植后寿命最长的20%已故供体肾脏将首先分配给预期移植后存活率最高的20%候选人;然后将不接受的肾脏提供给剩余的80%候选人。等待时间将从维持透析开始时开始（即使在列名之前）或从估计肾小球滤过率为20 mL/min/1.73 m（2）或更低的列名时开始。在当前系统下，等待名单上的候选人数量持续增加，因为每年增加的候选人多于删除的候选人。成年人的平均等待时间从2003年的3年增加到2009年的4.5年以上。捐赠率没有增加。短期结果继续改善;移植后90天的死亡删失移植物存活率为97%或更高的死亡供体移植和99%以上的活体供体移植。2013年，883名儿科候选人被添加到等待名单中; 2013年名单上65.8%的儿科候选人接受了已故供体移植。年龄小于11岁的活体供体受体的5年移植物存活率最高（89%），年龄在11至17岁的死亡供体受体的5年移植物存活率最低（68%）。
A new kidney allocation system, expected to be implemented in late 2014, will characterize donors on a percent scale (0%-100%) using the kidney donor profile index (KDPI). The 20% of deceased donor kidneys with the greatest expected posttransplant longevity will be allocated first to the 20% of candidates with the best expected posttransplant survival; kidneys that are not accepted will then be offered to remaining 80% of candidates. Waiting time will start at the time of maintenance dialysis initiation (even if before listing) or at the time of listing with an estimated glomerular filtration rate of 20 mL/min/1.73 m(2) or less. Under the current system, the number of candidates on the waiting list continues to increase, as each year more candidates are added than are removed. Median waiting times for adults increased from 3 years in 2003 to more than 4.5 years in 2009. Donation rates have not increased. Short-term outcomes continue to improve; death-censored graft survival at 90 days posttransplant was 97% or higher for deceased donor transplants and over 99% for living donor transplants. In 2013, 883 pediatric candidates were added to the waiting list; 65.8% of pediatric candidates on the list in 2013 underwent deceased donor transplant. Five-year graft survival was highest for living donor recipients aged younger than 11 years (89%) and lowest for deceased donor recipients aged 11 to 17 years (68%).