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在新冠疫情时代恢复已故捐赠者肾移植:患者想要什么?

Resuming Deceased Donor Kidney Transplantation in the COVID-19 Era: What Do Patients Want?

作者信息

Thind Amarpreet K, Beckwith Hannah, Dattani Rakesh, Dhutia Amrita, Gleeson Sarah, Martin Paul, Ryan Louise, Shuaib Rishana, Svetitsky Shuli, Dor Frank J M F, Brown Edwina A, Willicombe Michelle

机构信息

Division of Immunology and Inflammation, Department of Medicine, Centre for Inflammatory Disease, Imperial College London, London, United Kingdom.

Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom.

出版信息

Transplant Direct. 2021 Mar 5;7(4):e678. doi: 10.1097/TXD.0000000000001126. eCollection 2021 Apr.

Abstract

BACKGROUND

The rapidly evolving novel coronavirus 2019 (COVID-19) pandemic bought many kidney transplant (KT) programs to a halt. Integral to resuming KT activity is understanding the perspectives of potential transplant candidates during this highly dynamic time.

METHODS

From June 1 to July 7, 2020, a telephone survey of KT candidates on the deceased donor waiting list at Imperial College Renal and Transplant Centre in West London was conducted. The survey captured ongoing COVID-19 exposure risks and patients' views on waitlist (WL) reactivation and undergoing transplantation.

RESULTS

Two hundred seven responses were received. Of the respondents, 180 patients (87%) were happy to be reactivated onto the WL; with 141 patients (68%) willing to give consent to transplantation currently, while 53 patients (26%) felt unsure, and 13 patients (6%) would decline a KT. The vast majority of patients had no concerns. In the responses from those who were uncertain or who would decline a KT, concerns about COVID-19 infection and the need for reassurance from transplant units dominated. Universally patients wanted more information about COVID-19 infection risk with KT and the precautions being taken to reduce this risk.

CONCLUSIONS

The majority of surveyed patients are in favor of reactivation and receiving a KT despite the ongoing COVID-19 pandemic. Reactivation of candidates cannot be assumed and should take an individualized approach, incorporating clinical risk with patient perspectives. Improved communication with KT candidates is highly requested.

摘要

背景

迅速演变的2019新型冠状病毒(COVID-19)大流行使许多肾脏移植(KT)项目停滞不前。在这个高度动态的时期,了解潜在移植受者的观点对于恢复KT活动至关重要。

方法

2020年6月1日至7月7日,对伦敦西部帝国理工学院肾脏与移植中心已故供体等待名单上的KT候选人进行了电话调查。该调查记录了持续的COVID-19暴露风险以及患者对等待名单(WL)重新激活和接受移植的看法。

结果

共收到207份回复。在受访者中,180名患者(87%)乐意被重新列入WL;141名患者(68%)目前愿意同意接受移植,53名患者(26%)不确定,13名患者(6%)会拒绝KT。绝大多数患者没有担忧。在不确定或会拒绝KT的患者的回复中,对COVID-19感染的担忧以及需要移植单位给予保证占主导地位。患者普遍希望获得更多关于KT相关COVID-19感染风险以及为降低此风险所采取预防措施的信息。

结论

尽管COVID-19大流行仍在持续,但大多数接受调查的患者赞成重新列入WL并接受KT。不能假定候选人会重新列入WL,而应采取个体化方法,将临床风险与患者观点相结合。强烈要求改善与KT候选人的沟通。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3443/7935425/ff24d9bc846f/txd-7-e678-g001.jpg

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