Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany; Department of Internal Medicine III, Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Germany; Peter L. Reichertz Institute for Medical Informatics (PLTI), TU Braunschweig and Hannover Medical School, Hannover, Germany; German Organ Procurement Organization (DSO), Frankfurt am Main, Germany; Eurotransplant International Foundation, Leiden,Netherlands; Institute of Ethics and History of Medicine, University Medicine Göttingen, Göttingen, Germany; Division of Clinical Transplantation Medicine, Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig Holstein Campus Kiel, Kiel, Germany.
Dtsch Arztebl Int. 2024 Aug 23;121(17):559-565. doi: 10.3238/arztebl.m2024.0137.
Rigid age limits in the current allocation system for post-mortem donor kidneys in Germany may have problematic effects. The new German national transplantion registry enables data analysis with respect to this question.
Using anonymized data from the German national transplantion registry, we extracted and evaluated information on the recipients and postmortem donors of kidneys that were allocated in Germany through Eurotransplant over the period 2006-2020.
Data on 19 664 kidney transplantations in Germany from 2006 to 2020 were analyzed. The median waiting time for kidney transplantation was 5.8 years. Persons under age 18 waited a median of 1.7 years; persons aged 18 to 64, 7.0 years; and persons aged 65 and older, 3.8 years. Over the period of observation, postmortem kidneys were transplanted into 401 people of age 64 (2.0% of all organ recipients) and 1,393 people of age 65 (7.1% of all organ recipients). The difference in waiting times between allocation programs for persons under age 65 (ETKAS, "Eurotransplant Kidney Allocation System") and those aged 65 and older (ESP, "Eurotransplant Senior Program") increased over the period of observation, from 2.6 years in 2006-2010 to 4.1 years in 2017-2020.
The rigid age limits in the current allocation rules for post-mortem kidney donations in Germany are prolonging the waiting times for transplants among patients aged 18 to 64. We think these rules need to be fundamentally reassessed.
德国现行的死后器官分配制度中严格的年龄限制可能会产生有问题的影响。新的德国国家移植登记处使我们能够对此问题进行数据分析。
使用德国国家移植登记处的匿名数据，我们提取并评估了 2006 年至 2020 年间通过 Eurotransplant 在德国分配的肾脏接受者和死后供体的信息。
对 2006 年至 2020 年德国 19664 例肾移植的数据进行了分析。肾移植的中位等待时间为 5.8 年。18 岁以下的人等待时间中位数为 1.7 年；18 至 64 岁的人等待时间中位数为 7.0 年；65 岁及以上的人等待时间中位数为 3.8 年。在观察期间，有 401 名 64 岁（所有器官接受者的 2.0%）和 1393 名 65 岁（所有器官接受者的 7.1%）的死后肾脏被移植。2006-2010 年期间，年龄在 65 岁以下（ETKAS，“Eurotransplant 肾脏分配系统”）和年龄在 65 岁及以上（ESP，“Eurotransplant 高级计划”）的分配方案之间的等待时间差异为 2.6 年，到 2017-2020 年期间增加到 4.1 年。
德国现行的死后肾脏捐赠分配制度中严格的年龄限制延长了 18 至 64 岁患者的移植等待时间。我们认为这些规则需要进行根本性的重新评估。
