Department of Anesthesiology, University of Michigan Health System, Ann Arbor, MI, USA.
Am J Transplant. 2010 Feb;10(2):416-20. doi: 10.1111/j.1600-6143.2009.02931.x. Epub 2009 Dec 2.
The aims of this study were to determine whether Centers for Disease Control high risk (CDCHR) status of organ donors affects kidney utilization and recipient survival. Data from the Scientific Registry of Transplant Recipients were used to examine utilization rates of 45,112 standard criteria donor (SCD) deceased donor kidneys from January 1, 2005, and February 2, 2009. Utilization rates for transplantation were compared between CDCHR and non-CDCHR kidneys, using logistic regression to control for possible confounders. Cox regression was used to determine whether CDCHR status independently affected posttransplant survival among 25,158 recipients of SCD deceased donor kidneys between January 1, 2005, and February 1, 2008. CDCHR kidneys were 8.2% (95% CI 6.9-9.5) less likely to be used for transplantation than non-CDCHR kidneys; after adjusting for other factors, CDCHR was associated with an odds ratio of utilization of 0.67 (95% CI 0.61-0.74). After a median 2 years follow-up, recipients of CDCHR kidneys had similar posttransplant survival compared to recipients of non-CDCHR kidneys (hazard ratio 1.06, 95% CI 0.89-1.26). These findings suggest that labeling donor organs as 'high risk' may result in wastage of approximately 41 otherwise standard kidneys per year.
本研究旨在确定器官捐献者的疾病控制中心高危（CDCHR）状态是否影响肾脏的利用和受者的生存。利用移植受者科学注册处的数据，检查了 2005 年 1 月 1 日至 2009 年 2 月 2 日期间 45112 例标准标准供体（SCD）已故供体肾脏的利用率。使用逻辑回归控制可能的混杂因素，比较 CDCHR 和非 CDCHR 肾脏的移植利用率。使用 Cox 回归确定 CDCHR 状态是否独立影响 2005 年 1 月 1 日至 2008 年 2 月 1 日期间 25158 例 SCD 已故供体肾脏受者的移植后生存。CDCHR 肾脏用于移植的可能性比非 CDCHR 肾脏低 8.2%（95%CI 6.9-9.5）；在调整其他因素后，CDCHR 与利用率的比值比为 0.67（95%CI 0.61-0.74）相关。中位随访 2 年后，CDCHR 肾脏受者与非 CDCHR 肾脏受者的移植后生存相似（风险比 1.06，95%CI 0.89-1.26）。这些发现表明，将供体器官标记为“高危”可能导致每年浪费约 41 个标准肾脏。
