The medical evaluation of living kidney donors: A survey of US transplant centers
The medical evaluation of living kidney donors: A survey of US transplant centers
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DOI：
10.1111/j.1600-6143.2007.01932.x
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发表时间：
2007-10-01
影响因子：
8.8
通讯作者：
Rodrigue, J. R.
中科院分区：
文献类型：
--
作者：
Mandelbrot, D. A.;Pavlakis, M.;Rodrigue, J. R.
在美国，使用活体供体进行肾移植是很常见的，长期研究表明，年轻、健康的个体捐献肾脏是安全的。然而，移植项目几乎没有数据来指导他们决定哪些供体是不可接受的，以及哪些特征与肾脏疾病或捐赠后不良的社会心理结果有关。为了记录评估潜在供体的现行做法，我们调查了美国所有的肾移植项目。与12年前的一项调查相比，捐赠的医疗标准在一些领域更加包容。所有响应项目现在都接受无血缘关系的活体捐赠者。大多数项目不再有年龄上限。如果满足某些附加标准，项目现在更有可能接受接受高血压治疗的捐赠者，或者有肾结石病史的捐赠者。相比之下，捐赠的医学标准在其他领域更为严格，例如较年轻的捐赠者年龄和较低的肌酐清除率。总的来说，在用于评估供体的标准上，移植项目之间仍然存在显著的差异。这些发现突出表明，需要更多关于与捐赠有关的潜在疾病的各种类型供体的长期结果的数据。
The use of living donors for kidney transplantation in the United States is common, and long-term studies have demonstrated the safety of donation by young, healthy individuals. However, transplant programs have little data to guide them in deciding which donors are unacceptable, and which characteristics are associated with kidney disease or poor psychosocial outcomes after donation. To document current practices in evaluating potential donors, we surveyed all US kidney transplant programs. Compared to a survey 12 years ago, medical criteria for donation are more inclusive in several areas. All responding programs now accept living unrelated donors. Most programs no longer have an upper age limit to be eligible. Programs are now more likely to accept donors with treated hypertension, or a history of kidney stones, provided that certain additional criteria are met. In contrast, medical criteria for donation are more restrictive in other areas, such as younger donor age and low creatinine clearance. Overall, significant variability remains among transplant programs in the criteria used to evaluate donors. These findings highlight the need for more data on long-term outcomes in various types of donors with potential morbidities related to donation.