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活体供肾者肾切除术的当前趋势和短期结果:全国住院患者样本的基于人群分析。

Current trends and short-term outcomes of live donor nephrectomy: a population-based analysis of the nationwide inpatient sample.

机构信息

Department of Surgery, Surgical Outcomes Analysis & Research, University of Massachusetts Medical School, 55 Lake Avenue North, S6-432, Worcester, MA 01655, USA.

出版信息

World J Surg. 2010 Dec;34(12):2985-90. doi: 10.1007/s00268-010-0770-3.

DOI:10.1007/s00268-010-0770-3
PMID:20811748
Abstract

BACKGROUND

Recent United Network for Organ Sharing (UNOS) data suggest that live kidney donation is stagnant. Current practices and trends in laparoscopic donor nephrectomy (LDN) among the transplant community remain largely unknown.

MATERIALS AND METHODS

From the Nationwide Inpatient Sample (NIS) from 1998 to 2006, patients undergoing LDN (n = 9,437) were identified.

RESULTS

Live kidney donation in the United States did not show an increase in the NIS. Of the live donor cases recorded, 58 (0.61%) were associated with a major short-term complication. The number of LDNs performed by transplant surgeons decreased over the study period from 76.5% in 1998 to 30.4% in 2006.

CONCLUSIONS

In the United Stares, LDNs are performed safely with a low short-term complication rate. Despite the use of laparoscopy and the increased need of donor organs, the rate of LDN in kidney transplantation has not increased proportionally.

摘要

背景

最近美国器官共享联合网络(UNOS)的数据表明活体肾脏捐献趋于停滞。目前,移植领域腹腔镜供肾切除术(LDN)的实际操作和趋势在很大程度上仍不为人知。

材料与方法

从 1998 年至 2006 年全国住院患者样本(NIS)中,确定了行 LDN(n=9437)的患者。

结果

美国活体肾脏捐献在 NIS 中并未显示出增加。在记录的活体供体病例中,有 58 例(0.61%)出现主要短期并发症。在研究期间,由移植外科医生实施的 LDN 数量从 1998 年的 76.5%下降至 2006 年的 30.4%。

结论

在美国,LDN 的实施安全,短期并发症发生率低。尽管采用了腹腔镜技术且对供体器官的需求增加,但肾移植中 LDN 的比例并未相应增加。

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Clin J Am Soc Nephrol. 2013 Oct;8(10):1773-82. doi: 10.2215/CJN.12311212. Epub 2013 Sep 26.
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Better understanding live donor risk through big data.通过大数据更好地了解活体供者风险。
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Risks and outcomes of living donation.活体捐献的风险和结果。

本文引用的文献

1
Kidney and pancreas transplantation in the United States, 1999-2008: the changing face of living donation.美国 1999-2008 年的肾和胰腺移植:活体捐献者的变化。
Am J Transplant. 2010 Apr;10(4 Pt 2):987-1002. doi: 10.1111/j.1600-6143.2010.03022.x.
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Admission volume determines outcome for patients with acute pancreatitis.入院量决定急性胰腺炎患者的预后。
Gastroenterology. 2009 Dec;137(6):1995-2001. doi: 10.1053/j.gastro.2009.08.056. Epub 2009 Sep 3.
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Half of kidney transplant candidates who are older than 60 years now placed on the waiting list will die before receiving a deceased-donor transplant.
Adv Chronic Kidney Dis. 2012 Jul;19(4):220-8. doi: 10.1053/j.ackd.2011.09.005.
目前被列入等待名单的60岁以上的肾移植候选者中,有一半会在接受尸体供体移植前死亡。
Clin J Am Soc Nephrol. 2009 Jul;4(7):1239-45. doi: 10.2215/CJN.01280209. Epub 2009 Jun 18.
4
Kidney and pancreas transplantation in the United States, 1998-2007: access for patients with diabetes and end-stage renal disease.1998 - 2007年美国的肾与胰腺移植:糖尿病和终末期肾病患者的获取情况
Am J Transplant. 2009 Apr;9(4 Pt 2):894-906. doi: 10.1111/j.1600-6143.2009.02566.x.
5
Organ donation and utilization in the United States: 1998-2007.美国的器官捐赠与利用情况:1998 - 2007年
Am J Transplant. 2009 Apr;9(4 Pt 2):879-93. doi: 10.1111/j.1600-6143.2009.02565.x.
6
High volume and outcome after liver resection: surgeon or center?肝切除术后的手术量与预后:是外科医生还是医疗中心的影响?
J Gastrointest Surg. 2008 Oct;12(10):1709-16; discussion 1716. doi: 10.1007/s11605-008-0627-3. Epub 2008 Aug 13.
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Surgical specialization and operative mortality in hepato-pancreatico-biliary (HPB) surgery.肝胰胆(HPB)外科手术中的手术专业化与手术死亡率
J Gastrointest Surg. 2008 Sep;12(9):1534-9. doi: 10.1007/s11605-008-0566-z. Epub 2008 Jul 9.
8
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Surg Endosc. 2008 May;22(5):1181-7. doi: 10.1007/s00464-007-9732-8. Epub 2008 Feb 1.
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The impact of a formal minimally invasive service on the resident's ability to achieve new ACGME guidelines for laparoscopy.一项正规的微创服务对住院医师达到新的美国毕业后医学教育认证委员会(ACGME)腹腔镜检查指南要求的能力的影响。
J Surg Educ. 2007 Nov-Dec;64(6):420-3. doi: 10.1016/j.jsurg.2007.06.013.
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