The State of US Living Kidney Donors
The State of US Living Kidney Donors
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DOI：
10.2215/cjn.01510210
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发表时间：
2010-10-01
影响因子：
9.8
通讯作者：
Cooper, Mathew
中科院分区：
文献类型：
--
作者：
Davis, Connie L.;Cooper, Mathew
背景和目的：越来越多的活体肾脏捐献要求对活体肾脏捐赠者进行持续的健康风险评估和国家卫生政策的修订。设计、设置、参与者和测量：对1988年1月至2008年12月向器官采购和移植网络数据库报告的活体肾脏捐赠者进行审查，以了解轻微的医疗异常、是否存在捐赠者的医疗保健覆盖范围以及手术并发症和死亡的发生。结果：在2008年的捐献中，19.5%的人肥胖，2.0%的人有高血压病史，3.5%的人有蛋白尿。活体供者的GFR估计中位数为92.2ml/min。此外，据报道，12.2%的捐赠者在捐献时没有医疗保险。根据种族背景，14.9%的黑人和17.0%的西班牙裔捐赠者在捐赠时没有保险。围手术期并发症包括输血(0.4%)、再次手术(0.5%)和血管并发症(0.2%)。在1999年10月至2008年12月期间，0.03%的捐赠者在捐献后30天内死亡。在这些年里，捐献者的总死亡率为2.8%。结论：几乎四分之一的在世捐赠者的健康状况可能与未来的健康风险有关。有必要对这些捐助者进行密切的后续行动和登记。只有到那时，我们才能最准确地告知潜在的在世捐赠者，捐赠对他们的健康和生存的真正风险。此外，这些数据说明有必要就向活体捐赠者提供医疗保险问题进行全国性讨论。临床肾脏病5：1873-1880,2010。DOI：10.2215/CJN.01510210
Background and objectives: Increasing living kidney donation mandates ongoing assessment of living donors for future health risks and revision of national health policy.Design, setting, participants, & measurements: Living kidney donors as reported to the Organ Procurement and Transplant Network database from January 1988 through December 2008 were reviewed for minor medical abnormalities, presence of donor health care coverage, and occurrence of surgical complications and death.Results: At donation in 2008, 19.5% were obese, 2.0% had a history of hypertension, and 3.5% had proteinuria. The median estimated GFR of living donors was 92.2 ml/min. Additionally, 12.2% of donors were reported not to have health insurance at the time of donation. By racial background, 14.9% of black and 17.0% of Hispanic donors did not have insurance at donation. Perioperative complications included blood transfusion (0.4%), reoperation (0.5%), and vascular complications (0.2%). Death occurred within 30 days of donation in 0.03% donating between October 1999 and December 2008. During those same years, overall donor death was 2.8%.Conclusions: Almost one quarter of living donors have medical conditions that may be associated with future health risk. Close follow-up and a registry of these donors are necessary. Only then will we be able to inform prospective living donors most accurately of the real risk of donation on their health and survival. Additionally, these data speak to the need for a national discussion on the provision of health insurance for living donors. Clin J Am Soc Nephrol 5: 1873-1880, 2010. doi: 10.2215/CJN.01510210