Ministry of Health, Singapore.
Ann Acad Med Singap. 2017 Nov;46(11):424-432.
Transplant rates in Singapore have been falling and there is limited information on baseline characteristics and clinical outcomes of living kidney donors nationally. This study aimed to determine the safety of living kidney donor transplant in Singapore by exploring the proportion of donors that meets international selection guidelines and describing short-term clinical outcomes.
We analysed 472 donors who underwent nephrectomies from 1 January 2010 to 31 December 2014 from the Donor Care Registry. We described donor characteristics against 5 international guidelines and measured post-nephrectomy outcomes in 150 local donors for up to 24 months. A multivariate analysis was performed to determine the baseline variables associated with poorer outcomes.
There were more foreign than local donors, with differences in gender and hospital types. Selection was generally aligned with international recommendations although 3.0% (using the Chronic Kidney Disease Epidemiology [CKD-EPI] equation) to 8.5% (using radionuclide and creatinine clearance methods) of donors had inappropriate baseline estimated glomerular filtration rates (eGFR) forage. Post-procedure, many foreign donors were lost to follow-up. Over 24 months, eGFR decreased by 33.8% from baseline before recovering gradually to 29.6%. During this period, only 2 donors were admitted for renal or urological conditions and there were no cases of end-stage renal failure or deaths. A lower baseline eGFR (HR: 1.05; 95% Cl, 1.02 to 1.09) and older age (HR: 1.04; 95% Cl, 1.00 to 1.08) were associated with a post-nephrectomy eGFR of less than 60 mL/kg/1.73 m.
Kidney donation is safe in Singapore. Donor selection is in keeping with international guidelines and short-term outcomes are comparable to other cohorts.
新加坡的移植率一直在下降，关于全国活体肾脏捐献者的基线特征和临床结局的信息有限。本研究旨在通过探索符合国际选择标准的供体比例并描述短期临床结果来确定新加坡活体肾脏供体移植的安全性。
我们分析了 2010 年 1 月 1 日至 2014 年 12 月 31 日期间从供体护理登记处接受肾切除术的 472 名供体。我们根据 5 项国际指南描述了供体特征，并在 150 名当地供体中测量了长达 24 个月的术后结果。进行了多变量分析，以确定与较差结果相关的基线变量。
外国供体多于本地供体，在性别和医院类型方面存在差异。选择总体上与国际建议一致，尽管有 3.0%（使用慢性肾脏病流行病学[CKD-EPI]方程）至 8.5%（使用放射性核素和肌酐清除率方法）的供体的基线估计肾小球滤过率（eGFR）与年龄不匹配。术后，许多外国供体失访。在 24 个月内，eGFR 从基线下降了 33.8%，然后逐渐恢复到 29.6%。在此期间，只有 2 名供体因肾脏或泌尿系统疾病入院，没有终末期肾衰竭或死亡病例。基线 eGFR 较低（HR：1.05；95%Cl，1.02 至 1.09）和年龄较大（HR：1.04；95%Cl，1.00 至 1.08）与肾切除术后 eGFR 低于 60 mL/kg/1.73 m 相关。
在新加坡，肾脏捐献是安全的。供体选择符合国际指南，短期结果与其他队列相当。
