Kidney exchange match rates in a large multicenter clearinghouse.
Kidney exchange match rates in a large multicenter clearinghouse.
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DOI：
10.1111/ajt.14689
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发表时间：
2018-06
期刊：
影响因子：
--
通讯作者：
Segev DL
中科院分区：
文献类型：
--
作者：
Holscher CM;Jackson K;Chow EKH;Thomas AG;Haugen CE;DiBrito SR;Purcell C;Ronin M;Waterman AD;Garonzik Wang J;Massie AB;Gentry SE;Segev DL
肾配对捐献（KPD）可以促进与不相容供体的候选人的活体供体移植，但需要等待匹配，同时遭受透析的发病率。等待KPD与脱敏或死亡供体移植之间的平衡依赖于估计KPD等待时间的能力。我们使用竞争风险框架研究了2011年10月至2015年9月期间国家肾脏登记处（NKR）（一家大型多中心KPD信息交换所）的供体/候选人对。在1894名候选人中，52%为男性，中位年龄为50岁，66%为白色，59%为O型血，42% PRA>80，50%通过NKR获得KPD。至KPD的中位时间范围从ABO-A和PRA 0的候选人的2个月到ABO-O或PRA 98+的候选人的1年以上。PRA 80-97和98+的候选人与PRA 0候选人相比，匹配的可能性分别低23%（95% CI：6-37%）和83%（78-87%）。ABO-O候选人的匹配率比ABO-A候选人低67%（61-73%）。ABO-B或ABO-O供体的候选人比ABO-A供体的候选人匹配的可能性高31%（10-56%）和118%（82-162%）。提供者应建议候选人对KPD的现实，个性化的期望，特别是在他们的替代治疗方案的背景下。
Kidney paired donation (KPD) can facilitate living donor transplantation for candidates with an incompatible donor, but requires waiting for a match while suffering the morbidity of dialysis. The balance between waiting for KPD versus desensitization or deceased donor transplantation relies on the ability to estimate KPD wait times. We studied donor/candidate pairs in the National Kidney Registry (NKR), a large multi-center KPD clearinghouse, between 10/2011-9/2015 using a competing risk framework. Among 1894 candidates, 52% were male, median age was 50 years, 66% were white, 59% had blood type O, 42% had PRA>80, and 50% obtained KPD through NKR. Median times to KPD ranged from 2 months for candidates with ABO-A and PRA 0, to over a year for candidates with ABO-O or PRA 98+. Candidates with PRA 80-97 and 98+ were 23% (95% CI: 6-37%) and 83% (78-87%) less likely to be matched than PRA 0 candidates. ABO-O candidates were 67% (61-73%) less likely to be matched than ABO-A candidates. Candidates with ABO-B or ABO-O donors were 31% (10-56%) and 118% (82-162%) more likely to match than those with ABO-A donors. Providers should counsel candidates about realistic, individualized expectations for KPD, especially in the context of their alternative treatment options.
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影响因子：
6.2
作者：
Ferrari, Paolo;Cantwell, Linda;Holdsworth, Rhonda
通讯作者：
Holdsworth, Rhonda
影响因子：
2.1
作者：
Segev DL;Powe NR;Troll MU;Wang NY;Montgomery RA;Boulware LE
通讯作者：
Boulware LE
影响因子：
158.5
作者：
Orandi, B. J.;Luo, X.;Segev, D. L.
通讯作者：
Segev, D. L.
影响因子：
8.8
作者：
Segev, DL;Gentry, SE;Montgomery, RA
通讯作者：
Montgomery, RA
影响因子：
8.8
作者：
Massie, A. B.;Leanza, J.;Segev, D. L.
通讯作者：
Segev, D. L.