[REIN:一个有利于脏移植的工具]
Mathilde Prezelin-Reydit1, Thierry Lobbedez2, Mathilde Lassalle3
1Coordination régionale Aquitaine, Maison du Rein – AURAD Aquitaine, Gradignan, France
Nephrologie & therapeutique
|August 28, 2023
概括
法国晚期病 (ESKD) 患者获得移植的机会正在改善,但仍然具有挑战性. 预防性移植和等待名单注册正在增加,但基于患者年龄,并发病症和地区的差异仍然存在.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 法国脏流行病学和信息网络 (REIN) 登记处收集了对末期脏疾病 (ESKD) 患者脏移植和透析的数据.
- 了解获得移植的机会对于管理ESKD至关重要,ESKD是一种需要置换治疗的疾病.
- 国家卫生当局和研究网络提供了关于移植活动和患者等待名单的补充数据.
研究的目的:
- 总结法国国家ESKD注册 (REIN) 关于获得移植的贡献.
- 评估法国ESKD患者获得移植的趋势和差异.
- 确定影响等待名单注册和移植结果的因素.
主要方法:
- 分析来自法国国家REINESKD注册表的数据,包括脏移植和透析信息.
- 自2012年以来预防性移植和注册率趋势的评估.
- 根据患者特征和地区,评估对移植等待名单和实际移植的访问变化的变化.
主要成果:
- 自2012年以来,预防性移植和注册的比例有所增加,但仍然很低 (预防性移植~3-4%).
- 根据患者年龄,并发病 (糖尿病,肥胖) 和地区,获得等待名单和移植的机会有所不同.
- 透析开始时等候名单注册率和启动1年后的等候名单注册率有所增加,部分原因是2015年卫生当局的建议和REIN发表的差异研究.
- 2012年至2020年间,移植的平均等待时间增加了大约8个月.
- 接受第一次移植的概率随着时间的推移而保持稳定,但取决于患者的年龄,糖尿病状况和肥胖.
结论:
- 虽然ESKD患者获得移植的机会有所改善,但仍然存在重大挑战和差异.
- 增加的等候名单注册和预防性移植是积极的趋势,受到更新的指导方针和关于获取不平等问题的研究的影响.
- 患者特异性因素 (年龄,并发症) 和区域差异继续影响移植的获得,需要有针对性的干预措施.
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