Singh Sunita K, Jaure Allison, Caton Natasha, Johnston Olwyn, Hanson Camilla S, Dominello Amanda, Gill Maia P, Young Linnea, Yetzer Kathy, Chritchley Sarah, Chang Doris, Gill John S
Ajmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Clin J Am Soc Nephrol. 2024 Dec 1;19(12):1635-1642. doi: 10.2215/CJN.0000000000000547. Epub 2024 Oct 15.
In a survey of 685 previous living kidney donors, donors wanted lifelong annual follow-up with a primary care provider. Living donors wanted information on clinical and laboratory assessment and health reassurance. Donors also wanted access to specialized care in the event of hospitalization or change in health.
The long-term follow-up of living kidney donors is highly variable in Canada.
We surveyed perspectives on postdonation follow-up among 685 living donors in the two largest transplant programs in Canada (43% survey response rate). The anonymous survey was informed by semistructured interviews with 12 living kidney donors. The survey was developed on the basis of themes identified in the semistructured interviews, guidance from the research and clinical teams, and feedback from pilot testing with six previous donors.
Most (73%) of the respondents received follow-up after the first donation year from a primary care provider, and 70% reported annual follow-up visits, including blood and urine tests. Most (71%) received a follow-up reminder from their transplant center, and follow-up was higher (86% versus 68%) among those receiving reminders. Donors wanted specialist involvement if new health or kidney-related events occurred. Most (70%) were satisfied with their follow-up, and 66% endorsed annual lifelong follow-up. Donors wanted more information about lifestyle and living donor outcomes and wanted to contribute to research to increase understanding of long-term donor health outcomes.
Donors wanted annual lifelong follow-up, including clinical assessment and laboratory tests, and more information about their postdonation health. A transplant center–led, primary care provider–administered model of long-term follow-up may best meet the care and information needs of most donors.
在一项对685名既往活体肾供者的调查中，供者希望由初级保健提供者进行终身年度随访。活体供者希望获得临床和实验室评估信息以及健康保障。供者还希望在住院或健康状况改变时能够获得专科护理。
在加拿大，活体肾供者的长期随访差异很大。
我们调查了加拿大两个最大的移植项目中的685名活体供者对捐献后随访的看法（调查回复率为43%）。这项匿名调查是基于对12名活体供者的半结构化访谈开展的。该调查是根据半结构化访谈中确定的主题、研究和临床团队的指导意见以及对6名既往供者进行预试验的反馈而制定的。
大多数（73%）受访者在首次捐献年后接受了初级保健提供者的随访，70%的受访者报告进行了年度随访，包括血液和尿液检查。大多数（71%）受访者收到了移植中心的随访提醒，收到提醒的受访者的随访率更高（86%对68%）。如果出现新的健康或肾脏相关事件，供者希望有专科医生参与。大多数（70%）受访者对他们的随访感到满意，66%的受访者认可终身年度随访。供者希望获得更多关于生活方式和活体供者结局的信息，并希望为研究做出贡献，以增进对供者长期健康结局的了解。
供者希望进行终身年度随访，包括临床评估和实验室检查，以及更多关于他们捐献后健康状况的信息。由移植中心主导、初级保健提供者实施的长期随访模式可能最能满足大多数供者的护理和信息需求。
