Connaughton Dervla M, Harmon Grainne, Cooney Anne, Williams Yvonne, O'Regan John, O'Neill Derek, Cunningham Phyllis, Counihan Aileen, O'Kelly Patrick, McHale Siobhan, Denton Mark, O'Seaghdha Conall M, Magee Colm, Conlon Peter, Little Dilly, Keogan Mary, de Freitas Declan G
Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.
The National Histocompatibility and Immunogenetics Service for Solid Organ Transplantation, Beaumont Hospital, Dublin, Ireland.
Clin Transplant. 2016 Jan;30(1):17-25. doi: 10.1111/ctr.12641. Epub 2015 Nov 24.
Living donation is not only a method to increase access to kidney transplantation but can also offer superior outcomes. We report the experience of the living donor (LD) program in the Republic of Ireland and explore reasons why potential donors do not proceed to live donation.
Retrospective cohort study of all potential donors from January 2000 to March 2014 who presented wishing to undergo donor work-up and their subsequent outcomes.
A total of 956 donors for 496 recipients contacted the live kidney donation program of which 883 potential donors proceeded to the initial stage of assessment. The donor dropout rate at this stage was 64.2% (614/956 potential donors did not proceed to further evaluation). Thereafter, 269 (28.1%) donors underwent further assessment by the multidisciplinary team. In total, 93 (9.7%) donors were declined following this assessment with 176 (18.4%) donors ultimately proceeding to live kidney donation. The major reason for declining a donor was a medical contraindication (n = 63, 67.7%). In term of recipients, 54.2% (n = 269/496) had a potential donor proceed for further assessment of which 65.4% (n = 176/269) ultimately proceeding to live donation.
Further evaluation of the declined donor group is warranted to allow for expansion of the LD program.
活体捐赠不仅是增加肾移植可及性的一种方法，还能带来更好的结果。我们报告爱尔兰共和国活体捐赠者（LD）项目的经验，并探讨潜在捐赠者未进行活体捐赠的原因。
对2000年1月至2014年3月期间所有希望接受捐赠者检查的潜在捐赠者及其后续结果进行回顾性队列研究。
共有956名捐赠者为496名受者联系了活体肾捐赠项目，其中883名潜在捐赠者进入了初始评估阶段。此阶段的捐赠者退出率为64.2%（614/956名潜在捐赠者未进入进一步评估）。此后，269名（28.1%）捐赠者接受了多学科团队的进一步评估。在此评估后，共有93名（9.7%）捐赠者被拒绝，176名（18.4%）捐赠者最终进行了活体肾捐赠。拒绝捐赠者的主要原因是医学禁忌（n = 63，67.7%）。就受者而言，54.2%（n = 269/496）有潜在捐赠者进入进一步评估，其中65.4%（n = 176/269）最终进行了活体捐赠。
有必要对被拒绝的捐赠者群体进行进一步评估，以扩大活体捐赠项目。
