在活体脏捐赠后出现末期脏病的风险
Abimereki D Muzaale1, Allan B Massie1, Mei-Cheng Wang2
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
JAMA
|February 13, 2014
概括
与健康的非捐赠者相比,脏捐赠者面临末期脏疾病 (ESRD) 的风险略高. 然而,对于脏捐赠者来说,ESRD风险的绝对增加很小,为捐赠决定提供了信息.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 公共卫生 公共卫生
背景情况:
- 以前对脏捐赠者的末期脏疾病 (ESRD) 风险进行比较时,使用了一般人群,其中包括高风险,未经查的个人.
- 更准确的风险评估需要将脏捐赠者与类似查的健康非捐赠者队列进行比较.
研究的目的:
- 为了比较脏捐赠者和健康的非捐赠者队列之间的ESRD风险.
- 根据患者人口统计学来分层ESRD风险.
主要方法:
- 一组96,217名脏捐赠者和20,024名健康非捐赠者 (NHANES III) 与医疗保险数据联系在一起.
- 末期病 (ESRD) 定义为透析开始,等候名单上排名或移植接收.
- 随访时间延长至15年,捐赠者的随访时间中位数为7.6年,非捐赠者的随访时间为15年.
主要成果:
- 15年后,脏捐赠者的ESRD风险为1万分之30.8,健康非捐赠者的ESRD风险为1万分之3.9 (P < .001).
- 这种增加的风险在黑人和白人中都被观察到.
- 估计的终身ESRD风险为每10,000名捐赠者中有90人,而每10,000名健康非捐赠者中有14人.
结论:
- 脏捐赠者与匹配的健康非捐赠者相比,患ESRD的风险较高.
- 对于脏捐赠者来说,ESRD风险的绝对增加很小.
- 研究结果可以为有关活捐献的风险和益处的讨论提供信息.
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