A Donor Utilization Index to Assess the Utilization and Discard of Deceased Donor Kidneys Perceived as High Risk
A Donor Utilization Index to Assess the Utilization and Discard of Deceased Donor Kidneys Perceived as High Risk
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DOI：
10.2215/cjn.02770319
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发表时间：
2019-11-07
影响因子：
9.8
通讯作者：
Mohan, Sumit
中科院分区：
文献类型：
--
作者：
Brennan, Corey;Husain, Syed Ali;Mohan, Sumit
背景与目的
越来越多等待肾移植的患者表明，需要在确保可接受结果的同时，尽可能有效地利用尽可能多的逝世供者肾脏。评估地区和中心层面关于废弃的器官利用情况，可以揭示因风险认知而导致的次优逝世供者肾脏接受模式的地区差异。
设计、环境、参与者及测量
我们利用逻辑回归模型，根据2010年至2016年为移植获取的113640例逝世供者肾脏的高风险供者特征和废弃率，创建了一个加权供者利用指数，并使用它来检查182个每年进行超过15例逝世供者肾脏移植的成人移植中心对逝世供者肾脏的利用情况。线性回归和相关性用于分析供者利用指数的差异。
结果
发现供者利用指数在器官获取与移植网络地区之间存在显著差异（P
Background and objectivesAn increasing number of patients on the waitlist for a kidney transplant indicates a need to effectively utilize as many deceased donor kidneys as possible while ensuring acceptable outcomes. Assessing regional and center-level organ utilization with regards to discard can reveal regional variation in suboptimal deceased donor kidney acceptance patterns stemming from perceptions of risk.Design, setting, participants, & measurementsWe created a weighted donor utilization index from a logistic regression model using high-risk donor characteristics and discard rates from 113,640 deceased donor kidneys procured for transplant from 2010 to 2016, and used it to examine deceased donor kidney utilization in 182 adult transplant centers with >15 annual deceased donor kidney transplants. Linear regression and correlation were used to analyze differences in donor utilization indexes.ResultsThe donor utilization index was found to significantly vary by Organ Procurement and Transplantation Network region (P