远程医疗在肾移植中的应用范围:获取和延伸服务。
The Scope of Telemedicine in Kidney Transplantation: Access and Outreach Services.
机构信息
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
出版信息
Adv Chronic Kidney Dis. 2021 Nov;28(6):542-547. doi: 10.1053/j.ackd.2021.10.003.
Access to transplant centers is a key barrier for kidney transplant evaluation and follow-up care for both the recipient and donor. Potential kidney transplant recipients and living kidney donors may face geographic, financial, and logistical challenges in engaging with a transplant center and maintaining post-transplant continuity of care. Telemedicine via synchronous video visits has the potential to overcome the access barrier to transplant centers. Transplant centers can start the evaluation process for potential recipients and donors via telemedicine, especially for those who have challenges to come for an in-person visit or when there are restrictions on clinic capacities, such as during a pandemic. Similarly, transplant centers can use telemedicine to sustain post-transplant follow-up care while avoiding the burden of travel and its associated costs. However, expansion to telemedicine-based kidney transplant services is substantially dependent on telemedicine infrastructure, insurer policy, and state regulations. In this review, we discuss the practice of telemedicine in kidney transplantation and its implications for expanding access to kidney transplant services and outreach from pretransplant evaluation to post-transplant follow-up care for the recipient and donor.
移植中心的可及性是接受者和供者进行肾脏移植评估和后续护理的关键障碍。潜在的肾脏移植受者和活体肾脏供者在与移植中心接触并维持移植后护理的连续性方面可能会面临地理、财务和后勤方面的挑战。通过同步视频访问的远程医疗有可能克服移植中心的可及性障碍。移植中心可以通过远程医疗开始对潜在受者和供者进行评估,特别是对于那些难以亲自就诊的人,或者当诊所容量受到限制时,例如在大流行期间。同样,移植中心可以使用远程医疗来维持移植后的随访护理,同时避免旅行的负担及其相关费用。然而,基于远程医疗的肾脏移植服务的扩展在很大程度上取决于远程医疗基础设施、保险公司政策和州法规。在这篇综述中,我们讨论了远程医疗在肾脏移植中的应用及其对扩大肾脏移植服务的可及性以及从移植前评估到接受者和供者移植后随访护理的推广的影响。