Alejo Jennifer L, Luo Xun, Massie Allan B, Henderson Macey L, DiBrito Sandra R, Locke Jayme E, Purnell Tanjala S, Boyarsky Brian J, Anjum Saad, Halpern Samantha E, Segev Dorry L
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA.
Clin Transplant. 2017 Jul;31(7). doi: 10.1111/ctr.12992. Epub 2017 Jun 5.
Annual visits with a primary care provider (PCP) are recommended for living kidney donors to monitor long-term health postdonation, yet adherence to this recommendation is unknown.
We surveyed 1170 living donors from our center from 1970 to 2012 to ascertain frequency of PCP visits pre- and postdonation. Interviews occurred median (IQR) 6.6 (3.8-11.0) years post-transplant. We used multivariate logistic regression to examine associations between donor characteristics and PCP visit frequency.
Overall, only 18.6% had less-than-annual PCP follow-up postdonation. The strongest predictor of postdonation PCP visit frequency was predonation PCP visit frequency. Donors who had less-than-annual PCP visits before donation were substantially more likely to report less-than-annual PCP visits postdonation (OR= 14.4 P<.001). Men were more likely to report less-than-annual PCP visits postdonation (adjusted OR= 1.6 P<.01); this association was amplified in unmarried/noncohabiting men (aOR= 3.9 P<.001). Donors without college education were also more likely to report less-than-annual PCP visits postdonation (aOR= 1.8 , P=.001).
The importance of annual PCP visits should be emphasized to all living donors, especially those with less education, men (particularly single men), and donors who did not see their PCP annually before donation.
建议活体肾供体每年与初级保健提供者（PCP）进行一次随访，以监测捐献后的长期健康状况，但对这一建议的依从性尚不清楚。
我们对1970年至2012年来自本中心的1170名活体供体进行了调查，以确定捐献前后PCP随访的频率。访谈在移植后中位数（IQR）6.6（3.8 - 11.0）年进行。我们使用多变量逻辑回归来检验供体特征与PCP随访频率之间的关联。
总体而言，只有18.6%的人在捐献后接受PCP随访的频率低于每年一次。捐献后PCP随访频率的最强预测因素是捐献前PCP随访频率。捐献前PCP随访频率低于每年一次的供体，在捐献后报告PCP随访频率低于每年一次的可能性要大得多（OR = 14.4，P <.001）。男性在捐献后报告PCP随访频率低于每年一次的可能性更大（调整后的OR = 1.6，P <.01）；这种关联在未婚/非同居男性中更为明显（调整后的OR = 3.9，P <.001）。未接受大学教育的供体在捐献后报告PCP随访频率低于每年一次的可能性也更大（调整后的OR = 1.8，P =.001）。
应向所有活体供体强调每年进行PCP随访的重要性，尤其是那些受教育程度较低的人、男性（特别是单身男性）以及在捐献前未每年看PCP的供体。
