University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA.
Am J Surg. 2021 Jul;222(1):36-41. doi: 10.1016/j.amjsurg.2020.12.035. Epub 2020 Dec 24.
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.
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.
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).
Advocacy training was beneficial for self-advocates, but having an independent advocate may increase the likelihood of LDKT.
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。
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。
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）。
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。
