Burdick J F, Williams G M
Ann Surg. 1986 Mar;203(3):311-4. doi: 10.1097/00000658-198603000-00017.
Results in 195 renal transplants were compared for two distinct patient populations, those from the out-of-town surrounding rural region and those from the local large metropolitan center. The 1-year cadaver kidney survival was strikingly higher in the group from out-of-town (62% vs. 43%, p less than 0.001). This was partially due to better patient survival in the out-of-town patients. There were more blacks in the local group (7% vs. 48%, p less than 0.001). However, this was not the explanation for the difference, since within the local group the 1-year graft survival for nonblack recipients was no better than for blacks. Other relevant factors were not different between the two groups. This strong dialysis center effect, which exerts a major influence on the subsequent likelihood of success, derives from some factor related to the derivation of the recipient. In addition to its possible implications for patient care, further study of this phenomenon would also be useful with regard to recent interest on the part of government and other third-party payment groups in transplant center results.
对195例肾移植的结果在两个不同的患者群体中进行了比较，一组来自外地周边农村地区，另一组来自当地的大型都市中心。外地组的1年尸体肾存活率显著更高（62%对43%，p<0.001）。这部分是由于外地患者的存活率更高。当地组中的黑人比例更高（7%对48%，p<0.001）。然而，这并不是差异的原因，因为在当地组中，非黑人受者的1年移植物存活率并不比黑人更好。两组之间的其他相关因素并无差异。这种强烈的透析中心效应，对后续成功的可能性有重大影响，源于与受者来源相关的某些因素。除了对患者护理可能产生的影响外，对这一现象的进一步研究对于政府和其他第三方支付团体近期对移植中心结果的关注也将是有用的。
