The discard of deceased donor kidneys in the UK
The discard of deceased donor kidneys in the UK
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DOI：
10.1111/ctr.12319
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发表时间：
2014-03-01
影响因子：
2.1
通讯作者：
Bradley, J. Andrew
中科院分区：
文献类型：
--
作者：
Callaghan, Chris J.;Harper, Simon J. F.;Bradley, J. Andrew
最大限度地减少不必要的丢弃已获得的死亡供体肾脏是至关重要的，但关于丢弃率和可以避免丢弃的程度的信息有限。英国移植登记处的分析显示，采购的死亡供体肾脏的丢弃率从2002-3年的5%增加到2011-12年的12%。2006年，英国推出了一个全国性的肾脏供应系统（肾脏衰竭计划），但直到2012年，只有13%的肾脏被丢弃。为了检查丢弃的适当性，对来自13名已故供体的20个连续丢弃的肾脏进行了评估，以确定外科医生是否同意它们不可植入的决定。供体的中位（范围）年龄为67（31-80）岁。在丢弃之前，肾脏已提供给中位数为3（1-12）个中心。4个（20%）被丢弃的肾脏被认为是可用的，9个（45%）可能是可用的。由于这些发现，英国已故捐赠者肾脏提供系统的重大变化已经实施，包括同时提供和更广泛的进入标准难以放置的肾脏。组织变革是必要的，以提高利用死者捐赠肾脏。
It is essential to minimize the unnecessary discard of procured deceased donor kidneys, but information on discard rates and the extent to which discard can be avoided are limited. Analysis of the UK Transplant Registry revealed that the discard rate of procured deceased donor kidneys has increased from 5% in 2002-3 to 12% in 2011-12. A national offering system for hard-to-place kidneys was introduced in the UK in 2006 (the Declined Kidney Scheme), but just 13% of kidneys that were subsequently discarded until 2012 were offered through the scheme. In order to examine the appropriateness of discard, 20 consecutive discarded kidneys from 13 deceased donors were assessed to determine if surgeons agreed with the decision that they were not implantable. Donors had a median (range) age of 67 (31-80)yr. Kidneys had been offered to a median of 3 (1-12) centers before discard. Four (20%) of the discarded kidneys were thought to be usable, and nine (45%) were possibly usable. As a result of these findings, major changes to the UK deceased donor kidney offering system have been implemented, including simultaneous offering and broader entry criteria for hard-to-place kidneys. Organizational changes are necessary to improve utilization of deceased donor kidneys.