OPTN/SRTR 2018 Annual Data Report: Kidney
OPTN/SRTR 2018 Annual Data Report: Kidney
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DOI：
10.1111/ajt.15673
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发表时间：
2020-01-01
影响因子：
8.8
通讯作者：
Israni, A. K.
中科院分区：
文献类型：
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作者：
Hart, A.;Smith, J. M.;Israni, A. K.
尽管器官需求和供应之间存在严重的不匹配，但2018年的数据显示了一些有希望的趋势。连续第四年，美国等待肾移植的患者数量下降，而死者和活体肾移植的数量增加。这些令人鼓舞的趋势受到持续挑战的影响，例如大部分已收载患者的透析时间超过5年。65岁及以上的候选人比例持续上升，上市后5年内接受移植的比例在全国范围内继续存在巨大差异，在捐献服务地区从10%到近80%。从丙型肝炎阳性供体和缺氧性脑损伤供体中回收器官的趋势日益增加，需要进行持续监测，因为近20%的回收器官正在被丢弃。虽然活体捐赠者移植的数量增加了，但活体捐赠者与已故捐赠者的比例仍然存在种族差异。引人注目的是，在未来1-2年内，肾移植受者的总数有望超过25万。2018年，儿童肾移植总数保持稳定在756例。令儿科界深感担忧的是，活体肾移植的水平一直很低，2018年仅占36.2%。
Despite the ongoing severe mismatch between organ need and supply, data from 2018 revealed some promising trends. For the fourth year in a row, the number of patients waiting for a kidney transplant in the US declined and numbers of both deceased and living donor kidney transplants increased. These encouraging trends are tempered by ongoing challenges, such as a large proportion of listed patients with dialysis time longer than 5 years. The proportion of candidates aged 65 years or older continued to rise, and the proportion undergoing transplant within 5 years of listing continued to vary dramatically nationwide, from 10% to nearly 80% across donation service areas. Increasing trends in the recovery of organs from hepatitis C positive donors and donors with anoxic brain injury warrant ongoing monitoring, as does the ongoing discard of nearly 20% of recovered organs. While the number of living donor transplants increased, racial disparities persisted in the proportion of living versus deceased donors. Strikingly, the total number of kidney transplant recipients alive with a functioning graft is on track to pass 250,000 in the next 1-2 years. The total number of pediatric kidney transplants remained steady at 756 in 2018. Deeply concerning to the pediatric community is the persistently low level of living donor kidney transplants, representing only 36.2% in 2018.