住宅社区的劣势和获得移植的机会
Yiting Li1, Gayathri Menon1, Byoungjun Kim1
1Department of Surgery, New York University Grossman School of Medicine, New York.
JAMA network open
|December 30, 2025
概括
生活在弱势社区减少了获得脏移植 (KT) 候选名单和实际移植的机会,尤其对黑人来说. 这凸显了有针对性的干预措施的必要性,以解决结构性障碍,并促进公平的知识技术获取.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
背景情况:
- 邻里处于不利地位是慢性疾病差距的一个重要因素.
- 它对移植 (KT) 准入和种族差异的影响尚不清楚.
研究的目的:
- 调查社区劣势与获得KT等候名单和移植之间的关联.
- 为了检查这种关联如何因种族和种族而异.
主要方法:
- 使用美国国家注册表 (2015-2021) 进行回顾性队列研究.
- 包括末期病 (ESKD) 和KT候选人的成年人.
- 使用复合分数评估邻居的劣势,并使用因果特异性危险模型分析等待列表和KT结果.
主要成果:
- 在所有种族中,高邻居劣势与等待名单 (AHR 0.71) 和接受KT (AHR 0.89) 的几率较低有关.
- 处于高度不利地区的黑人个人接受任何KT (AHR 0.60),活体捐赠者KT (AHR 0.23) 和预防性KT (AHR 0.22) 的几率明显较低.
- 活体捐赠者和预防性KT的差异是持久的,并因邻里处于不利地位而加剧.
结论:
- 居住在高度不利的社区与减少对脏移植等待名单和接收的机会有关.
- 在特定类型的KT中,邻里处于不利地位加剧了现有的种族和民族差异.
- 解决结构性障碍和社区接触的干预措施对于公平的知识技术获取至关重要.
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