根据患者年龄的不同趋势 种族差异 脏移植 获取
Jade Buford1, Jessica L Harding2, Mengyu Di1
1Regenstrief Institute, Indianapolis, Indiana, USA.
Kidney international reports
|August 15, 2025
概括
对于黑人成年人,特别是年轻人来说,在移植获得方面存在种族差异. 虽然已故的捐赠者移植获得改善了黑人患者,活着的捐赠者移植获得恶化,需要修订的战略.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 健康差异 在健康上的差异
背景情况:
- 非西班牙裔黑人 (黑人) 和非西班牙裔白人 (白人) 人口之间的移植机会的种族差异一直是令人持续关注的.
- 虽然整体差异已经减少,但特定于年龄和移植阶段的趋势仍然不清楚.
研究的目的:
- 分析透析或等待名单上的成年患者在移植获得的种族差异趋势.
- 通过不同年龄组和移植步骤 (等待名单,活体捐赠脏移植,已故捐赠脏移植) 检查这些趋势.
主要方法:
- 从2005年至2019年,利用美国脏数据系统 (USRDS) 追踪患者到2021年.
- 分析了1,091,206名开始透析的成年人和226,703名等候名单上的成年人,分为三个时期 (2005-2009,2010-2014,2015-2019).
- 采用多变量调整的分发风险模型来评估年龄种族差异的变化.
主要成果:
- 等候名单上的差异整体上没有改善,而在年轻的成年人 (18-29岁) 中则恶化.
- 黑人患者更有可能接受已故供体脏移植 (DDKT),但不太可能接受活体供体脏移植 (LDKT),LDKT差异恶化.
- 在所有年龄组中,在LDKT获取方面存在显著差异,特别是在老年人 (65-80岁) 中.
结论:
- 在移植获取方面的种族差异在所有年龄组和移植步骤中并没有持续改善.
- 需要特别注意解决活体捐赠者移植获得的持续差异,特别是年轻和年长的黑人成年人.
- 重新审视提高黑人弱势群体移植机会的战略至关重要.
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