Cunningham Joan, Cass Alan, Anderson Kate, Snelling Paul, Devitt Jeannie, Preece Cilla, Eris Josette
Nephrol Dial Transplant. 2006 May;21(5):1178-83. doi: 10.1093/ndt/gfl029. Epub 2006 Feb 20.
The demand for deceased donor kidneys far outweighs the supply. The rate of living kidney donation (LKD) has been steadily increasing world-wide and is associated with excellent outcomes for the recipient. With respect to donors' outcomes, however, a strong evidence base is lacking. This study explores the attitudes and perceptions of Australian nephrologists towards LKD, specifically regarding donor risk, their willingness to recommend LKD and their own preparedness to become a live donor.
A postal survey of Australian nephrologists was conducted. Responses to six multiple choice questions about LKD were collected as a separate focus of a larger study.
We achieved a survey response rate of 52.4% and analysed responses from 184 practicing nephrologists and trainees. Australian nephrologists and trainees were generally supportive of LKD. The vast majority (95%) of respondents indicated that they would recommend it to a suitable donor or would themselves (97%) donate a kidney to an immediate family member. However, fewer than half (43%) would recommend LKD to a potential donor, where their relative's end-stage kidney disease (ESKD) had been attributed to diabetes and where there was a strong family history of diabetes. A minority thought that LKD increased the donor's risk of mortality (12%) or of ESKD (25%). Few nephrologists (4%) indicated their preparedness to be an altruistic donor--to a recipient unknown to them.
Although LKD is clearly supported by the nephrologists, the increasing incidence of ESKD attributable to diabetes, now the leading cause of ESKD in Australia, might, however, progressively limit its use. Meeting the growing demand for kidney transplantation will require an increased supply of both live and deceased donor kidneys. We should develop, evaluate and implement best-practice approaches to achieve this.
对已故捐赠者肾脏的需求远远超过供应。活体肾移植（LKD）的比例在全球范围内一直在稳步上升，并且与受体的良好预后相关。然而，关于捐赠者的预后，缺乏有力的证据基础。本研究探讨了澳大利亚肾病学家对LKD的态度和看法，特别是关于捐赠者风险、他们推荐LKD的意愿以及他们自己成为活体捐赠者的准备情况。
对澳大利亚肾病学家进行了邮寄调查。收集了关于LKD的六个多项选择题的回答，作为一项更大规模研究的一个单独重点。
我们的调查回复率为52.4%，并分析了184名执业肾病学家和实习生的回复。澳大利亚肾病学家和实习生普遍支持LKD。绝大多数（95%）的受访者表示，他们会向合适的捐赠者推荐LKD，或者自己（97%）会将肾脏捐献给直系亲属。然而，不到一半（43%）的人会向潜在捐赠者推荐LKD，前提是其亲属的终末期肾病（ESKD）归因于糖尿病且有强烈的糖尿病家族史。少数人认为LKD会增加捐赠者的死亡风险（12%）或ESKD风险（25%）。很少有肾病学家（4%）表示他们准备成为利他性捐赠者——向他们不认识的受体捐赠。
尽管LKD显然得到了肾病学家的支持，但在澳大利亚，现在ESKD的主要病因是糖尿病，因糖尿病导致的ESKD发病率不断上升，这可能会逐渐限制其应用。要满足不断增长的肾移植需求，需要增加活体和已故捐赠者肾脏的供应。我们应该制定、评估和实施最佳实践方法来实现这一目标。
