Reeves-Daniel A, Adams P L, Daniel K, Assimos D, Westcott C, Alcorn S G, Rogers J, Farney A C, Stratta R J, Hartmann E L
Department of Internal Medicine, Wake Forest University Health Sciences, Winston-Salem, NC 27157, USA.
Clin Transplant. 2009 Jan-Feb;23(1):39-46. doi: 10.1111/j.1399-0012.2008.00898.x. Epub 2008 Sep 11.
African Americans (AA) and women are less likely to receive a live kidney donor (LKD) transplant than Caucasians or men. Reasons for non-donation are poorly understood.
A retrospective review of 541 unsuccessful LKD was performed to explore reasons for non-donation and to assess for racial and/or gender differences.
We identified 138 AA and 385 Caucasian subjects who volunteered but did not successfully donate. Females (58.2%) were more likely to be excluded than males due to reduced renal function (glomerular filtration rate < 85 mL/min, 7.9% vs. 0.9%, p < 0.0001) or failure to complete the evaluation (6.4% vs. 1.8%, p = 0.01). AA were more commonly excluded due to obesity (body mass index >or= 32 kg/m(2); 30.4% AA vs. 16.6% Caucasian, p = 0.0005) or failure to complete the evaluation (12.3% AA vs. 1.8% Caucasian, p < 0.0001) whereas Caucasians were more often excluded due to kidney stones (1.5% AA vs. 7.3% Caucasian, p = 0.01).
Significantly different reasons for exclusion of LKD exist between potential Caucasian and AA LKD, particularly among women. Among the differences that we observed are potentially modifiable barriers to donation including obesity and failure to complete the donor evaluation. A further understanding of these barriers may help point to strategies for more effective recruitment and successful LKD.
与白种人或男性相比，非裔美国人（AA）和女性接受活体肾移植（LKD）的可能性较小。非捐赠的原因尚不清楚。
对541例未成功的LKD进行回顾性研究，以探讨非捐赠的原因并评估种族和/或性别差异。
我们确定了138名AA和385名白种人受试者，他们自愿参与但未成功捐赠。由于肾功能下降（肾小球滤过率<85 mL/分钟，7.9%对0.9%，p<0.0001）或未能完成评估（6.4%对1.8%，p = 0.01），女性（58.2%）比男性更有可能被排除。AA更常因肥胖（体重指数≥32 kg/m²；30.4%的AA对16.6%的白种人，p = 0.0005）或未能完成评估（12.3%的AA对1.8%的白种人，p<0.0001）而被排除，而白种人更常因肾结石（1.5%的AA对7.3%的白种人，p = 0.01）被排除。
潜在的白种人和AA LKD之间存在显著不同的LKD排除原因，尤其是在女性中。我们观察到的差异包括肥胖和未能完成捐赠者评估等可能可改变的捐赠障碍。对这些障碍的进一步了解可能有助于指明更有效的招募策略和成功的LKD。
