Living Kidney Donors: Current State of Affairs
Living Kidney Donors: Current State of Affairs
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DOI：
10.1053/j.ackd.2009.05.007
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发表时间：
2009-07-01
影响因子：
2.9
通讯作者：
Davis, Connie L.
中科院分区：
文献类型：
--
作者：
Davis, Connie L.
活体肾脏捐赠仍然是移植的基石。为了不断确定活体捐赠对供者是安全的，我们需要定期回顾文献，回顾联合器官共享网络数据库中可能使供者处于危险中的特征，并在数据库中搜索开始透析和/或列入移植名单的供者。此外，我们必须鼓励资助研究，对大量不同的捐助者进行终生跟踪，以便发现影响结果的关键特征。目前，可以说活体捐献总体上是安全的，几乎没有围手术期死亡、并发症或长期医疗问题。此外，活体供体反映了一般人群的人口统计数据，包括肥胖率的增加，一些供体患有高血压和低度蛋白尿。从长期来看，死亡率（对于白色供体）与一般人群没有什么不同，而终末期肾脏疾病的发病率略高于一般人群，从0.1%到1.1%不等。这种高风险在黑人捐献者中尤为明显。女性供体的先兆子痫发生率也可能略高于双肾供体。因此，在新的健康时代，医学界和管理人员有责任设计系统，允许对活体肾脏捐赠者，特别是有色人种进行更完整和持续的随访。(C) 2009年由国家肾脏基金会，Inc。版权所有
Living kidney donation continues as the cornerstone of transplantation. In order to determine with ever-renewing assurance that living donation is safe for the donor, we need to periodically review the literature review the United Network for Organ Sharing database for donor characteristics that may put them in danger, and scour databases for donors starting dialysis and/or listed for transplant. Additionally, we must encourage financing studies that follow large diverse cohorts of donors over their entire lifetimes in order to detect key characteristics that influence outcomes. Currently, it can be stated that living donation is, on the whole, safe, with few perioperative deaths, complications, or long-term medical issues. Additionally, the living donor reflects the demographics of the general population including increased rates of obesity with some donors having hypertension and low-grade proteinuria. In the long run, death rates (for the white donor) are no different than for the general population, whereas end-stage renal disease rates are slightly increased over the general population, ranging from 0.1% to 1.1%. The higher risk is especially notable in the black donor. Preeclampsia in female donors may also be marginally greater than in those with 2 kidneys. Thus, the new health age brings a rejuvenated responsibility of the medical community and those in governance to design systems that allow more complete and continued follow-up of the living kidney donor, especially those of color. (C) 2009 by the National Kidney Foundation, Inc. All rights reserved