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肾脏和肝脏活体供体:经验比较

Kidney and liver living donors: a comparison of experiences.

作者信息

Rudow Dianne LaPointe, Chariton Marian, Sanchez Carla, Chang Sara, Serur David, Brown Robert S

机构信息

Center for Liver Disease and Transplantation, New York Presbyterian Hospital Center, Columbia University, New York, NY, USA.

出版信息

Prog Transplant. 2005 Jun;15(2):185-91. doi: 10.1177/152692480501500213.

Abstract

BACKGROUND

Living donor kidney transplantation is considered a safe and effective means to treat end-stage renal disease, and has now exceeded the number of deceased donor kidney transplantations performed annually. Living donor liver transplantation is more controversial and has received criticism in the medical and lay community. Studies focus on recipient outcomes and medical safety. The impact of the donation on donors is not well understood.

OBJECTIVE

To compare experiences from both kidney and liver living donors, including their motivation, perceived risks, and postoperative experience.

METHODS

Questionnaires about the donation experience were mailed to 70 patients who underwent laparoscopic donor nephrectomy and 85 patients who underwent hepatectomy at a large academic medical center. Results of kidney and liver donors were compared.

RESULTS

No differences were found in mean age, marital status, ethnicity, relationship to the recipient, and employment status of the 2 groups. Women were more prevalent in both groups. The most common motivating factor in both kidney and liver donors was "because it was family," 81% and 82%, respectively. Kidney donors describe the decision to donate as easy compared to the liver donors (P = .049). In neither group did donors feel pressure to donate or have family conflicts regarding their decision to donate. Both groups felt they were well informed of the risks. Neither group described unexpected problems, and neither group regretted their decision to donate and would do it again if asked.

CONCLUSION

Donors in both groups reported favorable outcomes. A greater concern for risk of death, bleeding, altered appearance, and infection existed among liver donors compared to kidney donors. The actual outcomes were better than the perceived risks.

摘要

背景

活体供肾移植被认为是治疗终末期肾病的一种安全有效的方法,目前其每年的手术例数已超过尸体供肾移植。活体供肝移植则更具争议性,在医学领域和普通大众中都受到了批评。研究主要关注受者的结局和医疗安全性。捐赠对供者的影响尚未得到充分了解。

目的

比较肾和肝活体供者的经历,包括他们的动机、感知到的风险以及术后体验。

方法

向一家大型学术医疗中心的70例接受腹腔镜供肾切除术的患者和85例接受肝切除术的患者邮寄了关于捐赠经历的问卷。比较肾供者和肝供者的结果。

结果

两组在平均年龄、婚姻状况、种族、与受者的关系以及就业状况方面均未发现差异。两组中女性更为普遍。肾和肝供者最常见的动机都是“因为是家人”,分别为81%和82%。与肝供者相比,肾供者表示做出捐赠决定更容易(P = 0.049)。两组供者均未感到有捐赠压力,也没有因捐赠决定而产生家庭冲突。两组都觉得他们充分了解了风险。两组均未描述意外问题,也没有供者后悔自己的捐赠决定,若被再次问及是否愿意捐赠,他们都会再次同意。

结论

两组供者均报告了良好的结果。与肾供者相比,肝供者更担心死亡、出血、外观改变和感染的风险。实际结果优于感知到的风险。

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