Patients' preferences in transplantation from marginal donors: results of a discrete choice experiment
Patients' preferences in transplantation from marginal donors: results of a discrete choice experiment
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DOI：
10.1111/tri.12944
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发表时间：
2017-06-01
影响因子：
3.1
通讯作者：
Vidal-Trecan, Gwenaelle
中科院分区：
文献类型：
--
作者：
Kamran, Sara;Conti, Filomena;Vidal-Trecan, Gwenaelle
为了增加供体库，尽管患者对这些供体的偏好尚不清楚，但仍开发了从边缘供体移植的策略。采用离散选择实验法，对8个主要器官（肾、肝、心、肺）移植团队中登记在等待名单上或已经移植的患者的偏好进行评估。在2天的每一天，对患者进行四种情况的访谈。在178名符合条件的患者中，167人接受了访谈；40%的人在自己的情况下接受了边际贿赂，89%的人至少在其中一种情况下接受了边际贿赂。想象紧急情况或难以获得移植的罕见情况，分别有86%和71%的人接受了这些移植。大多数（76%）的人希望被告知这些移植物，43%的人希望参与决策。紧急情况[OR = 1.24；95% CI:(1.06-1.45)]和危险性[OR = 0.88；95% CI:(0.78-0.99)]是与移植边缘接受度独立相关的因素。大多数患者更愿意被告知并参与决策。边缘移植可能更容易被危重医疗情况或认为他们的情况危急的病人接受。应重新考虑医生在移植方面的做法，考虑到个人的偏好。这项研究是在一个国家进行的，因此反映了文化偏见和实践。
To increase the donor pool, the strategy of transplantation from marginal donors was developed though patients' preferences about these donors were insufficiently known. The preferences of patients registered on the waiting list or already transplanted in eight transplant teams covering four main organs (i.e., kidney, liver, heart, and lung) were evaluated using the discrete choice experiment method. In each left during 2 days, patients were interviewed on four scenarios. Of 178 eligible patients, 167 were interviewed; 40% accepted marginal graft in their own situation and 89% at least in one of the scenarios. Imagining urgent situations or rare profiles with difficult access to transplantation, respectively, 86% and 71% accepted these grafts. Most (76%) preferred to be informed about these grafts and 43% preferred to be involved in decision. The emergency [OR = 1.24; 95% CI: (1.06-1.45)] and the hazardousness [OR = 0.88; 95% CI: (0.78-0.99)] of the transplantation were factors independently associated with marginal graft acceptance. Most patients preferred to be informed and to be involved in the decision. Marginal grafts could be more accepted by patients in critical medical situations or perceiving their situation as critical. Physicians' practices in transplantation should be reconsidered taking into account individual preferences. This study was performed in a single country and thus reflects the cultural bias and practice thereof.