Edinburgh Transplant Centre, Royal Infirmary of Edinburgh.
Department of Clinical Surgery, University of Edinburgh, Edinburgh, UK.
Curr Opin Organ Transplant. 2021 Aug 1;26(4):347-352. doi: 10.1097/MOT.0000000000000895.
Renal transplantation offers the chance for patients with end-stage renal disease (ESRD) to have a significantly longer, healthier and better quality life compared with remaining on dialysis. Inequities have been demonstrated at multiple points in the transplantation pathway. In this review, the factors contributing to inequity in access to renal transplantation will be explored from a European perspective.
Despite improvements in patient assessment and revision of organ-offering schemes, there remain persistent inequities in access to the waiting list, allocation of a deceased donor transplant, receiving a living donor transplant and achieving preemptive transplantation. Older age, lower socioeconomic status and health literacy are key factors that continue to impact equity of access to transplantation.
A number of modifiable factors have been identified affecting access to transplantation, Increased patient education together with a better access to and promotion of living donation may help address some of these inequities.
目的综述：与透析治疗相比，肾移植可为终末期肾病（ESRD）患者提供更长、更健康和更高质量的生活机会。在移植途径的多个环节都存在不平等现象。在这篇综述中，我们将从欧洲的角度探讨导致肾移植机会不平等的因素。
最近的发现：尽管在患者评估和器官供应方案的修订方面有所改进，但在进入候补名单、分配已故供体移植、接受活体供体移植和实现抢先移植方面，仍存在持续的不平等现象。年龄较大、社会经济地位较低和健康素养是继续影响移植机会公平性的关键因素。
总结：已经确定了一些可改变的因素会影响到接受移植的机会，增加患者教育，以及更好地获取和促进活体捐献，可能有助于解决其中的一些不平等问题。
