Department of Surgery, Shands Hospital at the University of Florida, Gainesville, FL, USA.
Am J Kidney Dis. 2010 Jul;56(1):95-101. doi: 10.1053/j.ajkd.2010.01.014. Epub 2010 Mar 27.
Blood type AB kidney transplant candidates have the shortest waiting times, yet the current allocation system allows allocation of type A donor kidneys to type AB recipients.
United Network for Organ Sharing/Organ Procurement and Transplantation Network data between 1995 and 2004, retrospective observational study.
SETTING & PARTICIPANTS: 189,773 candidates listed for kidney-only transplant; 93,604 kidneys transplanted, 15,580 kidneys discarded.
Blood type and demographic/clinical variables.
OUTCOMES & MEASUREMENTS: The extent of disparities in waiting times and concurrent differences in recovery, discard, live donor, and deceased donor transplant rates.
Blood type O, A, B, and AB candidates constituted 48%, 34%, 14%, and 4% of the list, respectively. Live donor transplant rates were lowest for type AB candidates (13.4% vs 15.5%, 16.8%, and 15.2%; P < 0.001). On multivariate analysis, type AB candidates had a 1.5-fold greater chance of receiving deceased donor kidney transplants than blood group A candidates (95% CI, 1.45-1.55). Recovery rates of type AB kidneys were similar to those for other blood types, whereas discard rates of type AB kidneys were significantly higher (adjusted OR [aOR], 1.71; 95% CI, 1.56-1.89) for both expanded criteria (aOR, 1.78; 95% CI, 1.52-2.09) and standard criteria donors (aOR, 1.67; 95% CI, 1.48-1.89).
Observational data. Potential confounding from unmeasured covariates.
Allocation of type A kidneys to type AB recipients not only increases disparities in waiting times between these 2 groups; but concurrent with the shorter waiting times for type AB candidates, there is suboptimal use of type AB deceased donor and living donor kidneys.
AB 型血的肾移植候选者等待时间最短，但目前的分配系统允许将 A 型供体肾脏分配给 AB 型受者。
1995 年至 2004 年期间，美国器官共享联合网络/器官获取和移植网络的数据，回顾性观察研究。
189773 名仅接受肾移植的候选者；93604 个肾脏移植，15580 个肾脏被丢弃。
血型和人口统计学/临床变量。
等待时间的差异程度以及同时存在的恢复、丢弃、活体供体和已故供体移植率的差异。
O 型、A型、B 型和 AB 型候选者分别占名单的 48%、34%、14%和 4%。AB 型候选者的活体供体移植率最低（13.4%比 15.5%、16.8%和 15.2%；P < 0.001）。多变量分析表明，AB 型候选者接受已故供体肾移植的机会比 A 型血候选者高 1.5 倍（95%CI，1.45-1.55）。AB 型肾脏的恢复率与其他血型相似，而 AB 型肾脏的丢弃率明显更高（调整后的 OR[aOR]，1.71；95%CI，1.56-1.89），无论是扩展标准（aOR，1.78；95%CI，1.52-2.09）还是标准标准供体（aOR，1.67；95%CI，1.48-1.89）。
观察性数据。潜在的混杂因素未测量。
将 A 型肾脏分配给 AB 型受者不仅增加了这两组之间等待时间的差异；但随着 AB 型候选者等待时间的缩短，AB 型已故供体和活体供体肾脏的使用并不理想。
Zotero 插件