Section of Renal Transplantation, Edward Hines VA Jr. Hospital, Hines.
Department of Surgery, Division of Intra-Abdominal Transplantation, Stritch School of Medicine, Maywood, Illinois, USA.
Curr Opin Organ Transplant. 2021 Oct 1;26(5):542-546. doi: 10.1097/MOT.0000000000000912.
Living organ donation provides improved access to transplantation, thereby shortening transplant wait times and allowing for more deceased organ transplants. However, disparity in access to living donation has resulted in decreased rates of living donor transplants for some populations of patients.
Though there have been marked improvements in deceased donor equity, there are still challenges as it relates to gender, racial/ethnic, and socio-economic disparity. Improvements in living donation rates in Hispanic and Asian populations are tempered by challenges in African American rates of organ donation. Socio-economic disparity may drive gender disparities in organ donation resulting in disproportionate female living donors. Tailored approaches relating to language-specific interventions as well as directed educational efforts have helped mitigate disparity. Additionally, the use of apolipoprotein1 testing and modifications of glomerular filtration rate calculators may improve rates of African American donation. This review will evaluate recent data in living donor disparity as well as highlight successes in mitigating disparity.
Though there are still challenges in living donor disparity, many efforts at tailoring education and access as well as modifying living donor evaluation and identifying systemic policy changes may result in improvements in living donation rates.
活体器官捐献可增加器官移植的可及性，从而缩短移植等待时间，增加更多的已故器官捐献者。然而，活体捐献的可及性存在差异，导致某些患者群体的活体捐献移植率下降。
尽管已故供者公平性有了显著提高，但在性别、种族/民族和社会经济差异方面仍存在挑战。西班牙裔和亚裔人群的活体捐献率有所提高，但非洲裔美国人的器官捐献率却面临挑战。社会经济差异可能导致器官捐献中的性别差异，导致女性活体捐献者比例不成比例。针对语言特定干预措施和定向教育努力的定制方法有助于减少差异。此外，载脂蛋白 1 检测的使用和肾小球滤过率计算器的修改可能会提高非裔美国人的捐赠率。本综述将评估活体供者差异的最新数据，并强调在减少差异方面的成功。
尽管活体供者差异仍存在挑战，但通过定制教育和获取方式、修改活体供者评估以及确定系统政策变化等努力，可能会提高活体捐献率。
