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美国移动健康系统对活体肾供体两年随访依从性的影响。

Effectiveness of a Mobile Health System on Compliance With 2-Year Living Kidney Donor Follow-Up in the United States.

作者信息

Thomas Alvin G, Hussain Sarah, Klitenic Samantha B, Sidoti Carolyn N, Waldram Madeleine M, Chang Amy, Motter Jennifer D, Terlizzi Kelly, Massie Allan B, Schofield Mary, Barstow Karol, Bingaman Adam, Segev Dorry L, Levan Macey L

机构信息

Department of Surgery, NYU Langone Health, New York, New York, USA.

Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA.

出版信息

Clin Transplant. 2025 Apr;39(4):e70139. doi: 10.1111/ctr.70139.

Abstract

BACKGROUND

Organ Procurement and Transplantation Network (OPTN) policy requires 2 years of follow-up for living kidney donors (LKDs); however, many transplant hospitals struggle to meet this requirement. We developed and tested a mobile health (mHealth) system for LKD follow-up in a pilot randomized-controlled trial (RCT).

METHODS

LKDs were randomly assigned to either the intervention (mHealth + standard of care) or control arm (standard of care). We assessed OPTN policy-defined completeness and timeliness of 6-month, 1-year, and 2-year follow-ups. Four hundred LKDs were enrolled in the study (June 2018 to February 2021).

RESULTS

At 6-month follow-up, a higher proportion of the intervention arm participants completed composite visits (97.5% vs. 91.5%, p = 0.01). Both arms had similar compliance rates at 1- and 2-year follow-up (92.0% vs. 89.5%, p = 0.49, and 66.5% vs. 65.0%, p = 0.83). Intervention arm participants completed 6-month follow-up 11 days earlier than their counterparts (p = 0.009).

CONCLUSION

mHealth technologies improved 6-month follow-up, but did not impact 1- and 2-year LKD follow-up in this single-center RCT. Other strategies, such as providing services beyond data collection, may be necessary to improve donor engagement and support LDK's long-term follow-up.

摘要

背景

器官获取与移植网络(OPTN)政策要求对活体肾供体(LKDs)进行2年的随访;然而,许多移植医院难以满足这一要求。我们在一项试点随机对照试验(RCT)中开发并测试了一种用于LKD随访的移动健康(mHealth)系统。

方法

LKDs被随机分配到干预组(mHealth + 标准护理)或对照组(标准护理)。我们评估了OPTN政策定义的6个月、1年和2年随访的完整性和及时性。400名LKDs纳入了该研究(2018年6月至2021年2月)。

结果

在6个月的随访中,干预组参与者完成综合访视的比例更高(97.5%对91.5%,p = 0.01)。在1年和2年的随访中,两组的依从率相似(92.0%对89.5%,p = 0.49,以及66.5%对65.0%,p = 0.83)。干预组参与者比对照组提前11天完成了6个月的随访(p = 0.009)。

结论

在这项单中心RCT中,移动健康技术改善了6个月的随访,但对1年和2年的LKD随访没有影响。可能需要其他策略,如提供数据收集以外的服务,以提高供体的参与度并支持LDK的长期随访。

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本文引用的文献

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Clin Transplant. 2022 May;36(5):e14621. doi: 10.1111/ctr.14621. Epub 2022 Feb 27.
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OPTN/SRTR 2019 Annual Data Report: Kidney.OPTN/SRTR 2019 年度数据报告:肾脏。
Am J Transplant. 2021 Feb;21 Suppl 2:21-137. doi: 10.1111/ajt.16502.
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Risk of ESKD in Older Live Kidney Donors with Hypertension.患有高血压的老年活体肾供者发生终末期肾病的风险
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