Population Health Sciences, Bristol Medical School, Bristol, UK.
Renal Department, North Bristol NHS Trust, Bristol, UK.
BMJ Open. 2020 Jun 15;10(6):e033906. doi: 10.1136/bmjopen-2019-033906.
A living-donor kidney transplant is the best treatment for most people with kidney failure. Population cohort studies have shown that lifetime living kidney donor risk is modified by sex, age, ethnicity, body mass index (BMI), comorbidity and relationship to the recipient.
We investigated whether the UK population of living kidney donors has changed over time, investigating changes in donor demographics.
We undertook a cross-sectional analysis of the UK living kidney donor registry between January 2006 to December 2017. Data were available on living donor sex, age, ethnicity, BMI, hypertension and relationship to recipient.
UK living donor registry.
11 651 consecutive living kidney donors from January 2006 to December 2017.
Living kidney donor demographic characteristics (sex, age, ethnicity, BMI and relationship to the transplant recipient) were compared across years of donation activity. Donor characteristics were also compared across different ethnic groups.
Over the study period, the mean age of donors increased (from 45.8 to 48.7 years, p<0.001), but this change appears to have been limited to the White population of donors. Black donors were younger than White donors, and a greater proportion were siblings of their intended recipient and male. The proportion of non-genetically related non-partner donations increased over the 12-year period of analysis (p value for linear trend=0.002).
The increasing age of white living kidney donors in the UK has implications for recipient and donor outcomes. Despite an increase in the number of black, Asian and minority ethnic individuals waitlisted for a kidney transplant, there has been no increase in the ethnic diversity of UK living kidney donors. Black donors in the UK may be at a much greater risk of developing kidney failure due to accumulated risks: whether these risks are being communicated needs to be investigated.
对于大多数肾衰竭患者来说，活体供肾移植是最佳治疗方法。人群队列研究表明，终身活体供肾者的风险受性别、年龄、种族、体重指数（BMI）、合并症和与受者的关系等因素的影响。
我们调查了英国活体供肾者人群是否随时间发生了变化，研究了供者人口统计学特征的变化。
我们对 2006 年 1 月至 2017 年 12 月期间英国活体供肾者登记处进行了横断面分析。数据包括活体供者的性别、年龄、种族、BMI、高血压和与受者的关系。
英国活体供肾者登记处。
2006 年 1 月至 2017 年 12 月期间的 11651 名连续活体供肾者。
比较不同年份活体供肾者的人口统计学特征（性别、年龄、种族、BMI 和与移植受者的关系）。还比较了不同种族群体的供者特征。
在研究期间，供者的平均年龄增加（从 45.8 岁增加到 48.7 岁，p<0.001），但这种变化似乎仅限于白人供者。黑人供者比白人供者年轻，而且更大比例的人是他们预期受者的兄弟姐妹和男性。在 12 年的分析期间，非血缘关系的非配偶供肾的比例增加（线性趋势检验的 p 值=0.002）。
英国白人活体供肾者年龄的增加对受者和供者的结果都有影响。尽管等待肾移植的黑人、亚洲人和少数族裔个体的数量有所增加，但英国活体供肾者的种族多样性并没有增加。英国的黑人供者可能由于累积的风险而面临更大的肾衰竭风险：是否需要调查这些风险的沟通问题。
