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墨西哥韦拉克鲁斯州一家社会保障医院2018年肾脏移植等候名单年度分析

Annual Analysis (2018) of the Kidney Transplant Waiting List of a Social Security Hospital in Veracruz, Mexico.

作者信息

Martinez-Mier Gustavo, Gonzalez-Carrera Melissa Oryana, Vega-Quesada Helena Gabriela, Salazar-Pérez Mauricio, Viñas-Dozal Julio Cesar, Moreno-Ley Pedro I, Budar-Fernández Luis F, Méndez-López Marco T, Allende-Castellanos Carlos A, Jiménez-López Luis A, Bonilla-Casas Elias, De la Paz-Román Maritza, Fuentes-Zamudio Einar Eduardo

机构信息

Department of Organ Transplantation, IMSS UMAE Hospital de Especialidades, Veracruz, Mexico; Veracruz State College of Surgeons, Veracruz, Mexico.

School of Medicine, Universidad Veracruzana, Veracruz, México.

出版信息

Transplant Proc. 2020 May;52(4):1087-1089. doi: 10.1016/j.transproceed.2020.01.061. Epub 2020 Mar 13.

Abstract

BACKGROUND

In Mexico during 2018, 15,072 patients were waiting for a deceased donor kidney transplant, and 969 deceased donor kidney transplants were performed. There is no annual data report of the waiting list activity in Mexico. Herein, we analyzed our kidney transplant waiting list activity in 2018.

METHODS

We performed a waiting list analysis in our unit during 2018. Patient and status characteristics (active, deceased, inactive, or transplant) were registered. Differences between status were determined. A P < .05 was considered statistically significant.

RESULTS

In total, 467 patients were waiting, and 74 patients were included on the list (57.7% male, mean age 38.5 ± 11.3 years and mean BMI 24.9 ± 4.7 kg/m); 92.8% were state residents. The most common end-stage renal disease diagnosis was unknown (40.9%). In total, 94.9% were on dialysis (mean time 5.1 ± 3.14 years), and for 90.9%, this was the first transplant. PRA class I and class II were 19.9% ± 30.6% and 12.9% ± 27.1%, respectively. Mean EPTS was 19.8% ± 9.4%. Mean waiting time was 2.88 ± 2.3 years. In total, 21 deceased donor patients (3.9%) were transplanted; 57 (10.5%) patients had an inactive status, and 3 (0.6%) received a living donor kidney transplant with a proven mortality of 1.8% (n = 10). Patients who underwent deceased donor transplant were younger and had more time on dialysis, lower PRA class I, and more time on the waiting list (P < .05 by analysis of variance).

CONCLUSION

There are more patients included on the list than patients off the list. There are significant differences between patients who received a transplant and inactive and active patients that needs to be shortened.

摘要

背景

2018年在墨西哥,有15,072名患者等待已故捐赠者肾脏移植,共进行了969例已故捐赠者肾脏移植手术。墨西哥没有关于等待名单活动的年度数据报告。在此,我们分析了我们单位2018年的肾脏移植等待名单活动情况。

方法

我们对本单位2018年的等待名单进行了分析。记录了患者及状态特征(活跃、已故、不活跃或已移植)。确定了各状态之间的差异。P <.05被认为具有统计学意义。

结果

共有467名患者在等待,74名患者被列入名单(男性占57.7%,平均年龄38.5±11.3岁,平均BMI为24.9±4.7kg/m²);92.8%为该州居民。最常见的终末期肾病诊断不明(40.9%)。共有94.9%的患者接受透析(平均时间5.1±3.14年),其中90.9%是首次移植。群体反应性抗体I类和II类分别为19.9%±30.6%和12.9%±27.1%。平均欧洲移植尿毒症评分(EPTS)为19.8%±9.4%。平均等待时间为2.88±2.3年。共有21名已故捐赠者患者(3.9%)接受了移植;57名(10.5%)患者处于不活跃状态,3名(0.6%)接受了活体捐赠者肾脏移植,经证实死亡率为1.8%(n = 10)。接受已故捐赠者移植的患者更年轻,透析时间更长,群体反应性抗体I类更低,在等待名单上的时间更长(方差分析P <.05)。

结论

列入名单的患者多于未列入名单的患者。接受移植的患者与不活跃和活跃患者之间存在显著差异,等待时间需要缩短。

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