Jangi Majid, Sabbagh Mahin Ghorban, Nazemian Fateme, Hami Maryam, Tabesh Hamed, Tara Mahmoud
Clin Nephrol. 2019 Aug;92(2):55-64. doi: 10.5414/CN109618.
In end-stage renal disease (ESRD) kidneys stop functioning effectively, and transplantation is considered as the best therapeutic intervention. Because of the increasing number of ESRD patients and the limited number of organ donors, identification of the right candidates for kidney transplantation on the waiting lists is of great importance.
The purpose of the present study is to identify the factors affecting the prioritization of transplantation candidates based on the advice of a number of board-certified, local nephrologists.
This cross-sectional study was conducted in 2017 based on the Standard for Reporting Qualitative Research (SRQR) protocol. In the first phase, 15 nephrology specialists were interviewed to collect their viewpoints, and results were analyzed based on the tagging framework. Then, a collection of the resulting factors were compiled into a checklist and validated using a Delphi method by 11 specialists. Eventually, final factors were selected using a weighting method followed by a practicality checking step. Weighting of factors was done by the analytic hierarchy process (AHP) technique and Expert Choice 11.0 was used to analyze the weightings.
After removing duplicates, 35 factors were extracted. Finally, using a Delphi study and the weighting method and a subsequent practicality checking step, 12 factors were identified. Age, body mass index, time on dialysis, history of kidney transplantation, and 8 other factors were among the final identified factors. The factor with the highest weight was simultaneous disease.
Given the long waiting lists for kidney transplantation and the limited number of donated kidneys, selecting the candidate with highest priority is vital. Altogether, using these factors in the candidate identification process results in selecting the most suitable candidate for kidney transplantation; this may consequently increase the patient and graft survival rate.
在终末期肾病（ESRD）中，肾脏无法有效发挥功能，而移植被认为是最佳的治疗干预措施。由于ESRD患者数量不断增加以及器官捐献者数量有限，在等待名单上确定合适的肾移植候选人至关重要。
本研究的目的是根据一些获得当地认证的肾病专家的建议，确定影响移植候选人优先级的因素。
本横断面研究于2017年根据定性研究报告标准（SRQR）方案进行。在第一阶段，采访了15名肾病专家以收集他们的观点，并根据标签框架对结果进行分析。然后，将所得因素汇总成一份清单，并由11名专家使用德尔菲法进行验证。最终，通过加权法并随后进行实用性检查步骤来选择最终因素。因素的加权通过层次分析法（AHP）技术完成，并使用Expert Choice 11.0来分析权重。
去除重复项后，提取了35个因素。最后，通过德尔菲研究、加权法以及随后的实用性检查步骤，确定了12个因素。年龄、体重指数、透析时间、肾移植史以及其他8个因素是最终确定的因素。权重最高的因素是合并疾病。
鉴于肾移植等待名单长且捐赠肾脏数量有限，选择优先级最高的候选人至关重要。总之，在候选人识别过程中使用这些因素能够选出最适合肾移植的候选人；这可能进而提高患者和移植物的存活率。
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