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在活体捐赠者脏移植中心的种族平等,2008-2018年
Lisa M McElroy1, Tyler Schappe2, Dinushika Mohottige3
1Department of Surgery, Duke University School of Medicine, Durham, North Carolina.
JAMA network open
|December 15, 2023
概括
在活体捐赠脏移植 (LDKT) 中,种族差异仍然存在. 改善中心参与配对交换和优惠券计划可能会提高LDKT获取的种族平等.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 健康 公平 卫生 公平
背景情况:
- 获得活体捐赠移植 (LDKT) 的种族差异是一个重大问题.
- 影响LDKT种族平等的中心层面因素仍然不清楚.
研究的目的:
- 在11年的时间内,评估LDKT的中心级因素及其与种族平等的关联.
- 评估LDKT受益者之间的种族差异趋势.
主要方法:
- 2008-2018年美国移植中心的回顾性队列研究.
- 分析来自卫生资源服务管理局,美国脏数据系统和移植受体科学注册的数据.
- 计算黑白LDKT比率 (RRs) 和假设的最佳情景.
主要成果:
- 在研究期间,观察或调整的黑白LDKT比率 (RRs) 没有显著改善.
- 年度中心水平RRs在0.0557到0.771之间,中位数RRs在0.216和0.285.5之间.
- 假设的最佳情景表明,通过修改中心程序,黑人和白人患者的LDKT可能会增加.
结论:
- 这项研究发现,在11年的时间里,LDKT的种族平等没有显著改善.
- 可修改的中心特点,如参与配对交换和优惠券计划,以及增加公共保险准入,可能会改善种族平等.
- 需要进一步的研究来确定具体的中心级和基于计划的战略,以加强所有种族群体的LDKT访问.
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