Cuende N, Cuende J I, Fajardo J, Huet J, Alonso M
Andalusian Transplant Coordination Office, Seville, Spain.
Am J Transplant. 2007 Jun;7(6):1526-35. doi: 10.1111/j.1600-6143.2007.01792.x. Epub 2007 Apr 8.
This study analyzed the effect of population aging on organ donation for transplants in 43 countries and on the effectiveness of the donation process by comparing the results between Spain and the United States. The percentage of the population aged 65 or over accounted for 33% of the difference in the donation rates between the countries and for 91% of the variation in the rates after age adjustment. However, the level of aging of the Spanish (16.5%) and American (12.3%) populations failed to account for the percentages of deceased donors 65 or over (28% vs. 10%), due to the different age-specific donation rates, much higher in Spain above 50 years. These differences lead to a higher effectiveness of the process in the United States (3.1 transplanted organs per donor vs. 2.5 in Spain), though at lower rates of transplant per million population (73 vs. 87). We conclude that older populations have a greater donation potential as donation rates are strongly associated with population aging. It should therefore be mandatory to adjust donation rates for age before making comparisons. Additionally, effectiveness decreases with older donors, so age should be considered when establishing standards relating to organ donation and effectiveness of the process.
本研究通过比较西班牙和美国的结果，分析了43个国家人口老龄化对器官移植捐赠的影响以及捐赠过程的有效性。65岁及以上人口的比例占各国捐赠率差异的33%，占年龄调整后捐赠率变化的91%。然而，西班牙（16.5%）和美国（12.3%）的人口老龄化水平并不能解释65岁及以上已故捐赠者的比例（28%对10%），这是由于不同年龄组的捐赠率不同，在西班牙50岁以上的捐赠率要高得多。这些差异导致美国捐赠过程的效率更高（每位捐赠者移植3.1个器官，而西班牙为2.5个），尽管每百万人口的移植率较低（73对87）。我们得出结论，老年人口具有更大的捐赠潜力，因为捐赠率与人口老龄化密切相关。因此，在进行比较之前，强制对捐赠率进行年龄调整是必要的。此外，捐赠者年龄越大，效率越低，因此在制定与器官捐赠和捐赠过程有效性相关的标准时应考虑年龄因素。
