Physician and patient acceptance of policies to reduce kidney discard.
Physician and patient acceptance of policies to reduce kidney discard.
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DOI：
10.1111/ctr.14054
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发表时间：
2020-11
影响因子：
2.1
通讯作者：
Gordon EJ
中科院分区：
文献类型：
--
作者：
Mehrotra S;Schantz K;Friedewald JJ;Ladner DP;Becker Y;Formica R;Barah M;Gu J;Gordon EJ
尽管在美国移植肾脏短缺，但每年约有18%-20%的死亡供体肾脏被丢弃。这些废弃的肾脏可以为合适的患者提供生存益处。可能需要修改目前的肾脏分配政策，以减少死亡供体肾脏的丢弃。我们调查了移植医生和患者，以评估他们对减少死亡供体肾脏丢弃的政策建议的可接受性。专业协会（AST，ASTS）和患者组织（AAKP）的成员被邀请完成调查。从97名医生和107名患者中获得了答复。大多数医生（73.4%）和患者（73.8%）“在一定程度上”或“完全”接受了快速跟踪肾脏的政策，但存在丢弃风险。医生和患者还支持将等待时间的一部分返还给接受KDPI >85肾脏并在前12个月内经历移植失败的患者，36%的医生和50%的患者选择返还100%的等待时间。大多数医生（75%）“某种程度上或完全”接受一项政策，即跳过KDPI 90 +提供的不太积极的中心。医生和患者提供了深入了解的因素，研究人员和政策制定者应该考虑在设计和实施这些政策。
Despite the shortage of kidneys for transplantation in the United States, approximately 18%‐20% of deceased donor kidneys are discarded each year. These discarded kidneys can offer a survival benefit to suitable patients. Revisions to the current kidney allocation policy may be needed to reduce deceased donor kidney discard. We surveyed transplant physicians and patients to assess their perceived acceptability of policy proposals to reduce the discard of deceased donor kidneys. Members of professional societies (AST, ASTS) and a patient organization (AAKP) were invited to complete the survey. Responses were obtained from 97 physicians and 107 patients. The majority of physicians (73.4%) and patients (73.8%) "somewhat" or "completely" accepted a policy for fast‐tracking kidneys at risk of discard. Physicians and patients also supported returning a proportion of waiting time to patients who accept KDPI >85 kidneys and experience graft failure within the first 12 months, with 36% of physicians and 50% of patients electing to return 100% of the waiting time. The majority of physicians (75%) "somewhat or completely" accepted a policy to skip less aggressive centers for KDPI 90 + offers. Physicians and patients provided insights into factors researchers, and policymakers should consider in the design and implementation of these policies.
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影响因子：
19.6
作者：
Mohan, Sumit;Chiles, Mariana C.;Cohen, David J.
通讯作者：
Cohen, David J.
影响因子：
3.1
作者：
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通讯作者：
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影响因子：
2.1
作者：
Cooper, Matthew;Formica, Richard;Pastan, Stephen
通讯作者：
Pastan, Stephen
影响因子：
2.1
作者：
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通讯作者：
Bradley, J. Andrew
影响因子：
4.5
作者：
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通讯作者：
Conde JG