Navarro-González Alfonso, Arreola-Gutiérrez Monserrat, Barrera-De León Juan Carlos, Calderón-Alvarado Ana B, Becerra-Moscoso Mitzi R
Transplant - Urology and Nephrology Department, Pediatric Hospital, Western National Medical Center, Mexican Social Security Institute, Guadalajara, Mexico.
Research and Teaching Department, Pediatric Hospital, Western National Medical Center, Mexican Social Security Institute, Guadalajara, Mexico.
Transplant Proc. 2023 Jul-Aug;55(6):1469-1472. doi: 10.1016/j.transproceed.2023.02.040. Epub 2023 Mar 21.
Living donor kidney transplantation is the best type of renal replacement therapy for patients with end-stage renal disease. Living kidney donors (LKDs) undergo an extensive evaluation before donating, and many potential LKDs are declined. This study aimed to define the reasons for the decline in LKD candidates referred to our center.
We retrospectively analyzed clinical data of all potential LKDs evaluated between January 2001 and December 2021 at our institution,Western National Medical Center, Pediatric Hospital. Data were obtained by review of an electronic database.
A total of 1332 potential LKDs were evaluated, 796 (59.7%) successfully donated; 20 (1.5%) had a complete evaluation, were accepted for donation, and were on the waiting list for intervention; 56 (4.2%) continued in the evaluation process; 200 (15%) were discharged from the program due to administrative aspects, death (donor or receptor), or cadaveric renal transplantation in order of frequency; 56 (4.2%) withdraw by personal choice; and 204 (15.3%) were rejected for donation. Donor-related reasons included medical contraindications (n = 134, 65.7%), anatomic contraindications (n = 38, 18.6%), immunologic barriers (n = 18, 8.8%), and psychological reasons (n = 11, 5.4%).
Despite the large number of potential LKDs, a significant proportion did not proceed for donation for different reasons; in our description, it represents 40.3%. The largest proportion is because of donor-related causes, and most of the reasons result from the candidate's unnoticed chronic diseases.
活体供肾移植是终末期肾病患者最佳的肾脏替代治疗方式。活体肾供者（LKDs）在捐献前要接受全面评估，许多潜在的LKDs被拒绝。本研究旨在明确转诊至我们中心的LKD候选者被拒绝的原因。
我们回顾性分析了2001年1月至2021年12月在我们机构——西部国家医疗中心儿童医院接受评估的所有潜在LKDs的临床数据。数据通过查阅电子数据库获得。
共评估了1332名潜在LKDs，796名（59.7%）成功捐献；20名（1.5%）完成评估，被接受捐献并在等待干预名单上；56名（4.2%）继续处于评估过程中；200名（15%）因行政方面、死亡（供者或受者）或尸体肾移植等原因按频率顺序退出该项目；56名（4.2%）因个人选择退出；204名（15.3%）被拒绝捐献。与供者相关的原因包括医学禁忌（n = 134，65.7%）、解剖学禁忌（n = 38，18.6%）、免疫屏障（n = 18，8.8%）和心理原因（n = 11，5.4%）。
尽管有大量潜在的LKDs，但相当一部分因不同原因未进行捐献；在我们的描述中占40.3%。最大比例是由于与供者相关的原因，且大多数原因是候选者未被注意到的慢性疾病。
