Oniscu Gabriel C, Schalkwijk Annemarie A H, Johnson Rachel J, Brown Helen, Forsythe John L R
Transplant Unit, New Royal Infirmary of Edinburgh, Edinburgh EH16 4SA.
BMJ. 2003 Nov 29;327(7426):1261. doi: 10.1136/bmj.327.7426.1261.
To examine the access to the renal transplant waiting list and renal transplantation in Scotland.
Cohort study.
Renal and transplant units in Scotland.
4523 adults starting renal replacement therapy in Scotland between 1 January 1989 and 31 December 1999.
Impact of age, sex, social deprivation, primary renal disease, renal or transplant unit, and geography on access to the waiting list and renal transplantation.
1736 of 4523 (38.4%) patients were placed on the waiting list for renal transplantation and 1095 (24.2%) underwent transplantation up to 31 December 2000, the end of the study period. Patients were less likely to be placed on the list if they were female, older, had diabetes, were in a high deprivation category, and were treated in a renal unit in a hospital with no transplant unit. Patients living furthest away from the transplant centre were listed more quickly. The only factors governing access to transplantation once on the list were age, primary renal disease, and year of listing. A significant centre effect was found in access to the waiting list and renal transplantation.
A major disparity exists in access to the renal transplant waiting list and renal transplantation in Scotland. Comorbidity may be an important factor.
研究苏格兰肾移植等候名单的准入情况及肾移植情况。
队列研究。
苏格兰的肾脏及移植单位。
1989年1月1日至1999年12月31日期间在苏格兰开始接受肾脏替代治疗的4523名成年人。
年龄、性别、社会剥夺程度、原发性肾脏疾病、肾脏或移植单位以及地理位置对进入等候名单及肾移植的影响。
到研究期结束的2000年12月31日，4523名患者中有1736名（38.4%）被列入肾移植等候名单，1095名（24.2%）接受了移植。如果患者为女性、年龄较大、患有糖尿病、处于高度剥夺类别且在没有移植单位的医院的肾脏科室接受治疗，则他们被列入名单的可能性较小。居住在离移植中心最远的患者被列入名单的速度更快。一旦列入名单，决定能否进行移植的唯一因素是年龄、原发性肾脏疾病和列入名单的年份。在进入等候名单及肾移植方面发现了显著的中心效应。
苏格兰在进入肾移植等候名单及肾移植方面存在重大差异。合并症可能是一个重要因素。
