Race: A critical factor in organ donation, patient referral and selection, and orthotopic liver transplantation?
Race: A critical factor in organ donation, patient referral and selection, and orthotopic liver transplantation?
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DOI：
10.1002/lt.500040606
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发表时间：
1998-11-01
期刊：
影响因子：
--
通讯作者：
Bynon, S
中科院分区：
文献类型：
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作者：
Eckhoff, DE;McGuire, BM;Bynon, S
种族血统对器官捐献和肾移植后同种异体移植存活的影响一直存在争议。一些大型研究报道了黑人受者的同种异体肾移植存活率较低，而其他研究报告了相同的存活率。然而，种族问题与器官捐赠、患者转诊和原位肝移植患者选择有关，尚未调查。我们回顾了自1989年以来器官捐赠、患者转诊和选择以及原位肝移植的结果，由于该器官采购组织的协调一致的教育努力，黑人供体的百分比从1988年的6.1%增加到1996年的21.9%。自1989年肝移植项目成立以来，已有844名患者被转介到我们的移植中心进行器官移植评估。根据这些人群中终末期肝病的患病率，黑人患者（119例，14.1%）比白人患者（725例，85.9%）被转诊进行肝移植的人数少得不成比例。两组移植名单的接受率相似。实际接受移植的患者转诊百分比在种族界线上相似（黑人43%，白人42%）。然而，似乎黑人患者在转诊的较晚阶段进行肝移植，并且在转诊时病情更为严重。然而，黑人和白人患者的患者和移植物存活率相似。白人受者的1年和3年生存率分别为88%和81%，而黑人受者为96%和84%。在这个器官采购组织内，黑人捐赠在过去的10年里有所增加。不幸的是，在肝移植的转诊水平上可能存在选择偏差。然而，一旦患者转到该中心进行肝移植，白人和黑人患者的移植率和存活率相似。(C) 1998年由美国肝病研究协会发布。
The influence of ethnic origin on organ donation and renal allograft survival after renal transplantation has been controversial. Several large studies have reported inferior renal allograft survival in black recipients, whereas others have reported equal survival, However, the issue of race as it relates to organ donation, patient referral, and patient selection in orthotopic liver transplantation has not been investigated. We retrospectively reviewed our results of organ donation, patient referral and selection, and orthotopic liver transplantation since 1989, Because of a concerted educational effort by this organ procurement organization, the percentage of black donors has increased from 6.1% in 1988 to 21.9% in 1996, Since the inception of the Liver Transplant Program in 1989, 844 patients have been referred to our transplant center for organ transplant evaluation. Disproportionately fewer black patients (119; 14.1%) were referred for liver transplantation than white patients (725; 85.9%) based on the prevalence of end-stage liver disease in these populations. The acceptance rate for listing for transplantation was similar between the two groups. The percentage of patient referrals who actually underwent transplantation was similar across racial lines (43% black v42% white patients). However, it appeared that black patients were referred for liver transplantation at a later stage and were more critically ill at the time of referral. Nevertheless, the patient and graft survival were similar between black and white patients. The 1- and 3-year survival rates in white recipients was 88% and 81%, respectively, versus 96% and 84% in black recipients, Within this organ procurement organization, black donation has increased over the past 10 years. Unfortunately, there may be a selection bias at the level of referral for liver transplantation. However, once patients are referred to this center for liver transplantation, the rate of transplantation and survival is similar between white and black patients. (C) 1998 by the American Association for the Study of Liver Diseases.