自我倡导与活体供肾移植的可能性降低有关。
Self-advocacy is associated with lower likelihood of living donor kidney transplantation.
机构信息
University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA.
出版信息
Am J Surg. 2021 Jul;222(1):36-41. doi: 10.1016/j.amjsurg.2020.12.035. Epub 2020 Dec 24.
BACKGROUND
The Living Donor Navigator (LDN) Program pairs kidney transplant candidates (TC) with a friend or family member for advocacy training to help identify donors and achieve living donor kidney transplantation (LDKT). However, some TCs participate alone as self-advocates.
METHODS
In this retrospective cohort study of TCs in the LDN program (04/2017-06/2019), we evaluated the likelihood of LDKT using Cox proportional hazards regression and rate of donor screenings using ordered events conditional models by advocate type.
RESULTS
Self-advocates (25/127) had lower likelihood of LDKT compared to patients with an advocate (adjusted hazard ratio (aHR): 0.22, 95% confidence interval (CI): 0.03-1.66, p = 0.14). After LDN enrollment, rate of donor screenings increased 2.5-fold for self-advocates (aHR: 2.48, 95%CI: 1.26-4.90, p = 0.009) and 3.4-fold for TCs with an advocate (aHR: 3.39, 95%CI: 2.20-5.24, p < 0.0001).
CONCLUSIONS
Advocacy training was beneficial for self-advocates, but having an independent advocate may increase the likelihood of LDKT.
背景
活体供肾导航员（LDN）计划为肾移植候选人（TC）配对朋友或家庭成员进行宣传培训，以帮助识别供体并实现活体供肾移植（LDKT）。然而，一些 TC 作为独立的倡导者参与其中。
方法
在 LDN 计划中对 TC 进行的这项回顾性队列研究（2017 年 4 月至 2019 年 6 月）中，我们使用 Cox 比例风险回归评估了 LDKT 的可能性，并按倡导者类型使用有序事件条件模型评估了供体筛查率。
结果
与有倡导者的 TC 相比，独立倡导者（25/127）进行 LDKT 的可能性较低（调整后的危险比（aHR）：0.22，95%置信区间（CI）：0.03-1.66，p=0.14）。在 LDN 登记后，独立倡导者的供体筛查率增加了 2.5 倍（aHR：2.48，95%CI：1.26-4.90，p=0.009），有倡导者的 TC 增加了 3.4 倍（aHR：3.39，95%CI：2.20-5.24，p<0.0001）。
结论
宣传培训对独立倡导者是有益的，但有独立的倡导者可能会增加 LDKT 的可能性。
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