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活体肾捐献后的患者报告结局:单中心经验

Patient-Reported Outcomes Following Living Kidney Donation: A Single Center Experience.

作者信息

Rodrigue James R, Vishnevsky Tanya, Fleishman Aaron, Brann Tracy, Evenson Amy R, Pavlakis Martha, Mandelbrot Didier A

机构信息

Center for Transplant Outcomes and Quality Improvement, Transplant Institute, Beth Israel Deaconess Medical Center, 110 Francis Street, 7th Floor, Boston, MA, 02215, USA.

Harvard Medical School, Boston, MA, USA.

出版信息

J Clin Psychol Med Settings. 2015 Sep;22(2-3):160-8. doi: 10.1007/s10880-015-9424-9.

Abstract

This article describes the development and implementation of an initiative at one transplant center to annually assess psychosocial outcomes of living kidney donors. The current analysis focuses on a cohort of adults (n = 208) who donated a kidney at BIDMC between September 2005 and August 2012, in which two post-donation annual assessments could be examined. One and two year post-donation surveys were returned by 59 % (n = 123) and 47 % (n = 98) of LKDs, respectively. Those who did not complete any survey were more likely to be younger (p = 0.001), minority race/ethnicity (p < 0.001), and uninsured at the time of donation (p = 0.01) compared to those who returned at least one of the two annual surveys. The majority of donors reported no adverse physical or psychosocial consequences of donation, high satisfaction with the donation experience, and no donation decision regret. However, a sizable minority of donors felt more pain intensity than expected and recovery time was much slower than expected, and experienced a clinically significant decline in vitality. We describe how these outcomes are used to inform clinical practice at our transplant center as well as highlight challenges in donor surveillance over time.

摘要

本文描述了一家移植中心开展的一项倡议的发展与实施情况,该倡议旨在每年对活体肾供体的心理社会结果进行评估。当前的分析聚焦于2005年9月至2012年8月期间在贝斯以色列女执事医疗中心(BIDMC)捐献肾脏的成年人群体(n = 208),其中可以对捐献后的两次年度评估进行考察。分别有59%(n = 123)和47%(n = 98)的活体肾供体返回了捐献后一年和两年的调查问卷。与返回了两次年度调查问卷中至少一次的供体相比,那些未完成任何调查问卷的供体更有可能年龄较小(p = 0.001)、属于少数种族/族裔(p < 0.001),并且在捐献时未参保(p = 0.01)。大多数供体报告称捐献没有产生不良的身体或心理社会后果,对捐献经历高度满意,并且没有对捐献决定感到后悔。然而,有相当一部分少数供体感到疼痛强度超过预期,恢复时间比预期慢得多,并且活力出现了临床上显著的下降。我们描述了这些结果如何被用于为我们移植中心的临床实践提供信息,以及随着时间推移突出供体监测方面的挑战。

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