中国活体肾移植供受者术后的生活质量与心理状况
Quality of life and psychology after living-related kidney transplantation from donors and recipients in China.
作者信息
Zheng X Y, Han S, Wang L M, Zhu Y H, Zeng L, Zhou M S
机构信息
Organ Transplantation Institute of PLA, Changzheng Hospital, the Second Military Medical University, Shanghai, P.R. China.
Organ Transplantation Institute of PLA, Changzheng Hospital, the Second Military Medical University, Shanghai, P.R. China.
出版信息
Transplant Proc. 2014 Dec;46(10):3426-30. doi: 10.1016/j.transproceed.2014.04.014.
BACKGROUND
The state of organ transplantation in general in China is experiencing transition; however, living-donor organ transplantation has gained more attention recently. We have found that because traditional Chinese ideas, few Chinese transplantation surgeons have the quality of life (QOL) and mental health of living transplantation donors and recipients as their focus in care giving. Physicians outside of China typically have a different view. This study investigated QOL and psychology characteristics in Chinese living-related kidney donors and recipients after transplantation.
METHODS
Demographics, socioeconomics, transplantation processes, QOL scores, and psychosocial outcomes of 169 pairs of living-related kidney donors and recipients were analyzed using a self-made socio-demographic questionnaire, the short-form 36 health survey, and the Zung self-rating anxiety and depression scales.
RESULTS
The majority of both donors (81.8%, 90/110) and recipients (83.1%, 103/124) were at secondary school or lesser education levels. Eighty-five and five tenths percent (94/110) of donors and 54.8% (68/124) of recipients were of moderate or low incomes. In addition, the donors were predominantly female (61.8%, 68/110), 6 of whom (5.5%, 6/110) stated that their transplantation had a negative impact on marriage due to kidney donation. The evaluation of the donors' QOL was not significantly different from that of the Chinese norm. The recipients' QOL was obviously improved comparing with the hemodialysis patients. There was no anxiety and depression among donors, but slightly anxious (1.6%, 2/124) and depressive (5.6%, 7/124) symptoms were found among recipients.
CONCLUSION
Living-related kidney transplantation did not adversely affect the lives and psychological aspects of donors and significantly improved the QOL of recipients. Screening donors strictly, perfecting the medical care system, intensifying follow-up and social supports, and providing necessary healthy and psychological counseling should be fundamental prerequisites.
背景
中国器官移植的总体状况正处于转型期；然而，活体器官移植最近受到了更多关注。我们发现，由于传统的中国观念，很少有中国移植外科医生将活体移植供体和受体的生活质量（QOL）及心理健康作为护理重点。国外医生通常有不同的看法。本研究调查了中国亲属活体肾移植供体和受体移植后的生活质量及心理特征。
方法
使用自制的社会人口学问卷、简短健康调查问卷36项简表以及zung自评焦虑和抑郁量表，对169对亲属活体肾移植供体和受体的人口统计学、社会经济学、移植过程、生活质量评分及心理社会结果进行分析。
结果
大多数供体（81.8%，90/110）和受体（83.1%，103/124）为中学及以下文化程度。85.5%（94/110）的供体和54.8%（68/124）的受体为中等或低收入。此外，供体以女性为主（61.8%，68/110），其中6人（5.5%，6/110）表示，由于捐肾，她们的移植对婚姻产生了负面影响。供体的生活质量评估与中国常模无显著差异。与血液透析患者相比，受体的生活质量明显改善。供体中无焦虑和抑郁情况，但受体中发现有轻微焦虑（1.6%，2/124）和抑郁（5.6%，7/124）症状。
结论
亲属活体肾移植对供体的生活和心理方面没有不利影响，且显著改善了受体的生活质量。严格筛选供体、完善医疗体系、加强随访和社会支持以及提供必要的健康和心理咨询应是基本前提。
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