Hunt Heather F, Rodrigue James R, Dew Mary Amanda, Schaffer Randolph L, Henderson Macey L, Bloom Randee, Kacani Patrick, Shim Pono, Bolton Lee, Sanchez William, Lentine Krista L
Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) Living Donor Committee, Richmond, VA.
LIVE ON Organ Donation, Inc., Longmeadow, MA.
Curr Transplant Rep. 2018 Mar;5(1):27-44. doi: 10.1007/s40472-018-0181-1. Epub 2018 Feb 5.
Inadequate knowledge of the benefits, risks and opportunities for living donation is an important, potentially modifiable barrier to living donor transplantation. We assessed the current state of the evidence regarding strategies to increase knowledge, communication and access to living donor transplantation, as reported in peer-reviewed medical literature.
Nineteen studies were reviewed, categorized as programs evaluated in randomized controlled trials (8 studies) and programs supported by observational (non-randomized) studies (11 studies). Content extraction demonstrated that comprehensive education about living donation and living donor transplantation involves multiple learners - the transplant candidate, potential living donors, and social support networks - and requires communicating complex information about the risks and benefits of donation, transplantation and alternative therapies to these different audiences. Transplant centers can help transplant patients learn about living donor transplantation through a variety of formats and modalities, including center-based, home-based and remote technology-based education, outreach to dialysis centers, and social media. Evaluation of these strategies and program themes informed a new Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) public education brochure.
Increasing transplant candidate knowledge and comfort in talking about living donation and transplantation can reduce educational barriers to pursuit of living donor transplants. Ongoing efforts are needed to develop, refine and disseminate educational programs to help improve transplant access for more patients in need of organ donors.
对活体捐赠的益处、风险和机会了解不足是活体捐赠移植的一个重要的、可能可改变的障碍。我们评估了同行评审医学文献中报道的关于增加对活体捐赠移植的了解、沟通和获取机会的策略的现有证据状况。
共审查了19项研究,分为在随机对照试验中评估的项目(8项研究)和由观察性(非随机)研究支持的项目(11项研究)。内容提取表明,关于活体捐赠和活体捐赠移植的全面教育涉及多个学习者——移植候选人、潜在活体捐赠者和社会支持网络——并且需要向这些不同受众传达关于捐赠、移植和替代疗法的风险和益处的复杂信息。移植中心可以通过多种形式和方式帮助移植患者了解活体捐赠移植,包括基于中心的、基于家庭的和基于远程技术的教育、对透析中心的宣传以及社交媒体。对这些策略和项目主题的评估为新的器官获取与移植网络(OPTN)/器官共享联合网络(UNOS)公众教育手册提供了参考。
增加移植候选人对谈论活体捐赠和移植的了解并使其感到自在,可以减少寻求活体捐赠移植的教育障碍。需要持续努力来开发、完善和传播教育项目,以帮助更多需要器官捐赠者的患者改善移植机会。