Mandelbrot D A, Pavlakis M, Danovitch G M, Johnson S R, Karp S J, Khwaja K, Hanto D W, Rodrigue J R
Department of Medicine, The Transplant Center, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Am J Transplant. 2007 Oct;7(10):2333-43. doi: 10.1111/j.1600-6143.2007.01932.x.
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.
在美国，活体供肾移植很常见，长期研究已证明年轻健康个体捐赠的安全性。然而，移植项目几乎没有数据来指导他们决定哪些捐赠者不可接受，以及哪些特征与捐赠后肾病或不良心理社会结果相关。为了记录评估潜在捐赠者的当前做法，我们对美国所有肾脏移植项目进行了调查。与12年前的一项调查相比，捐赠的医学标准在几个方面更具包容性。所有回复的项目现在都接受非亲属活体捐赠者。大多数项目现在不再有年龄上限限制。只要满足某些额外标准，项目现在更有可能接受患有已治疗高血压或有肾结石病史的捐赠者。相比之下，捐赠的医学标准在其他方面更具限制性，如捐赠者年龄较小和肌酐清除率较低。总体而言，移植项目在评估捐赠者所使用的标准方面仍存在显著差异。这些发现凸显了需要更多关于各类有与捐赠相关潜在疾病的捐赠者长期结果的数据。
