University of Bristol and Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
The Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Kidney Int. 2017 Nov;92(5):1249-1260. doi: 10.1016/j.kint.2017.04.020. Epub 2017 Jul 12.
This multicenter prospective potential living kidney donor cohort study investigated which sociodemographic and other factors predict progression to living kidney donation or donor withdrawal as little is known on this topic. Therefore, we examined data on individuals undergoing living donor assessment at seven hospitals in the United Kingdom. Multivariable logistic regression was used to explore the relationships between donor and recipient characteristics and likelihood of kidney donation. A total of 805 individuals presented for directed donation to 498 intended recipients, of which 112 received a transplant from a living donor. Potential donors were less likely to donate if their intended recipient was female rather than male with an odds ratio of 0.60, a friend rather than relative 0.18, or had renal failure due to a systemic disease rather than another cause 0.41. The most socioeconomically deprived quintile was less likely to donate than the least 0.49, but the trend with deprivation was consistent with chance. Higher body mass index was associated with a lower likelihood of donation (odds ratio per each kg/m increase, 0.92). Younger potential donors (odds ratio per each year increase 0.97), those of nonwhite ethnicity 2.98, and friend donors 2.43 were more likely to withdraw from work-up. This is the first study in the United Kingdom of potential living kidney donors to describe predictors of non-donation. Qualitative work with individuals who withdraw might identify possible ways of supporting those who wish to donate but experience difficulties doing so.
这项多中心前瞻性潜在活体供肾者队列研究调查了哪些社会人口学和其他因素可预测活体供肾者向活体供肾或供肾撤回的转变，因为在这一主题上知之甚少。因此，我们检查了在英国 7 家医院接受活体供者评估的个体的数据。多变量逻辑回归用于探索供者和受者特征与肾脏捐赠可能性之间的关系。共有 805 人向 498 名预期受者进行了定向捐赠，其中 112 人接受了活体供者的移植。如果潜在供者的预期受者是女性而不是男性，则不太可能进行捐赠，其优势比为 0.60；如果是朋友而不是亲属，则优势比为 0.18；如果是由于系统性疾病而不是其他原因导致肾衰竭，则优势比为 0.41。最贫困的五分位数比最不贫困的五分位数更不可能捐赠，0.49，但与贫困相关的趋势与机会一致。较高的体重指数与捐赠可能性降低相关（每增加 1kg/m2 的优势比为 0.92）。潜在供者年龄越小（每增加 1 年的优势比为 0.97）、非白种人（优势比为 2.98）和朋友供者（优势比为 2.43）更有可能退出检查。这是英国首例描述潜在活体肾脏供者非捐赠预测因素的研究。对退出者进行定性研究可能会确定支持那些希望捐赠但遇到困难的人的可能方法。
