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潜在活体肾供体镰状细胞性状筛查:美国移植中心的政策与实践

Screening for sickle trait among potential live kidney donors: policies and practices in US transplant centers.

作者信息

Reese Peter Philip, Hoo Aaron Christopher, Magee Colm Christopher

机构信息

Renal, Hypertension and Electrolyte Division, University of Pennsylvania, Philadelphia, PA 19104, USA.

出版信息

Transpl Int. 2008 Apr;21(4):328-31. doi: 10.1111/j.1432-2277.2007.00611.x. Epub 2007 Dec 13.

Abstract

Sickle cell trait is common in the United States (US) and associated with abnormalities of renal function. Little is known, however, about the potential risk of sickle cell trait to live kidney donors. Using an original questionnaire, we assessed the policies and practices of US renal transplant centers with regard to screening for sickle trait among potential live kidney donors. Fifty-four percent (137/252) of centers responded. Eighty-three percent (113/137) of transplant centers had no policy to screen donors for sickle trait. Thirty-four percent (46/135) of centers reported actually screening donors for sickle trait in practice. Thirty-seven percent (39/105) of centers reported excluding donors with sickle trait always or most of the time. High volume centers (>100 live donor transplants/year) were more likely to screen for sickle trait (Fisher's exact, P = 0.03), but not more likely to exclude potential donors with sickle trait from donating. Most US renal transplant centers do not screen donors for sickle trait. Wide variation is evident in center practice regarding exclusion of donors on the basis of sickle trait. Research into the potential impact of sickle trait on renal function after donation is needed to guide transplant clinicians.

摘要

镰状细胞性状在美国很常见,且与肾功能异常有关。然而,对于镰状细胞性状对活体肾供者的潜在风险却知之甚少。我们通过一份原创问卷,评估了美国肾移植中心在潜在活体肾供者中筛查镰状细胞性状的政策和做法。54%(137/252)的中心做出了回应。83%(113/137)的移植中心没有筛查供者镰状细胞性状的政策。34%(46/135)的中心报告在实际操作中对供者进行了镰状细胞性状筛查。37%(39/105)的中心报告总是或大部分时间排除有镰状细胞性状的供者。高移植量中心(每年>100例活体供者移植)更有可能筛查镰状细胞性状(Fisher精确检验,P = 0.03),但不太可能排除有镰状细胞性状的潜在供者进行捐献。大多数美国肾移植中心不筛查供者的镰状细胞性状。在基于镰状细胞性状排除供者的中心做法上存在明显差异。需要研究镰状细胞性状对捐献后肾功能的潜在影响,以指导移植临床医生。

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