Lin M H, Tasi M K, Lin H Y, Lee C H, Chen S C, Lee P H
Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
Transplant Proc. 2010 Apr;42(3):689-91. doi: 10.1016/j.transproceed.2010.02.062.
Kidney transplantation provides a choice of active treatment for patients with chronic renal failure. However, the sources of organs are limited; therefore, living kidney donation is an alternative source. The regulation of organ donation in Taiwan stipulates that living organ donation is restricted to living related recipients. We sought to investigate factors that influenced or prevented individuals from living kidney donation in our center.
From January 2005 to December 2008, there were 266 potential candidates who underwent evaluation for living kidney donation in our center.
Among the potential candidates, most were spouses (n=85, 31.9%), followed by parents (n=67, 25.1%), siblings (n=62, 23.3%), and children (n=40, 15%). Eventually, 124 candidates (47%) completed organ donation, most of whom were siblings (n=39, 31.5%), then parents (n=38, 30.6%), spouses (n=26), and children (n=18). Most donors were females, including mothers and sisters. The most frequent reason to not donate was unwillingness, due to potential influences on their health, economic stress due to suspension of their job, and objection of family members. In 34 candidates (23.9%), adverse health factors of potential candidates prohibited them from donating, including age, chronic medical illness, hepatitis carrier status, severe depression, or mental retardation. Among 59 potential donor-recipient pairs with incompatible ABO blood types or highly sensitized to potential donors, 22 candidates completed living kidney donation.
Although laparoscopic nephrectomy for living kidney donation decreases the discomfort and hospital stay after donation, we can only promote living kidney donation if we can deal with the possible factors that prohibit candidates from living kidney donation, such as morbidity after organ donation, anxiety, or other factors. After analyzing those factors, we must also develop a protocol to closely follow the living kidney donors to ensure their health status and relieve their anxiety.
肾移植为慢性肾衰竭患者提供了积极的治疗选择。然而，器官来源有限，因此活体肾捐赠是一种替代来源。台湾的器官捐赠规定指出，活体器官捐赠仅限于有血缘关系的受者。我们试图调查影响或阻碍本中心个体进行活体肾捐赠的因素。
2005年1月至2008年12月，有266名潜在候选人在本中心接受了活体肾捐赠评估。
在潜在候选人中，大多数是配偶（n = 85，31.9%），其次是父母（n = 67，25.1%）、兄弟姐妹（n = 62，23.3%）和子女（n = 40，15%）。最终，124名候选人（47%）完成了器官捐赠，其中大多数是兄弟姐妹（n = 39，31.5%），然后是父母（n = 38，30.6%）、配偶（n = 26）和子女（n = 18）。大多数捐赠者为女性，包括母亲和姐妹。最常见的不捐赠原因是不愿意，这是由于担心对自身健康有潜在影响、因工作暂停导致经济压力以及家庭成员反对。在34名候选人（23.9%）中，潜在候选人的不良健康因素使其无法捐赠，包括年龄、慢性疾病、乙肝携带者状态、严重抑郁或智力障碍。在59对ABO血型不相容或对潜在捐赠者高度致敏的潜在供受者对中，22名候选人完成了活体肾捐赠。
尽管用于活体肾捐赠的腹腔镜肾切除术减少了捐赠后的不适和住院时间，但只有处理好可能阻碍候选人进行活体肾捐赠的因素，如器官捐赠后的发病率、焦虑或其他因素，我们才能促进活体肾捐赠。分析这些因素后，我们还必须制定一项方案，密切跟踪活体肾捐赠者，以确保他们的健康状况并缓解他们的焦虑。
