Allocation Rules and Age-Dependent Waiting Times for Kidney Transplantation.

IF 6.5 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Benedikt Kolbrink, Nassim Kakavand, Jakob C Voran, Helena U Zacharias, Axel Rahmel, Serge Vogelaar, Silke Schicktanz, Felix Braun, Roland Schmitt, Friedrich A von Samson-Himmelstjerna, Kevin Schulte
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引用次数: 0

Abstract

Background: Rigid age limits in the current allocation system for post-mortem donor kidneys in Germany may have problematic effects. The new German national transplantion registry enables data analysis with respect to this question.

Methods: Using anonymized data from the German national transplantion registry, we extracted and evaluated information on the recipients and postmortem donors of kidneys that were allocated in Germany through Eurotransplant over the period 2006-2020.

Results: Data on 19 664 kidney transplantations in Germany from 2006 to 2020 were analyzed. The median waiting time for kidney transplantation was 5.8 years. Persons under age 18 waited a median of 1.7 years; persons aged 18 to 64, 7.0 years; and persons aged 65 and older, 3.8 years. Over the period of observation, postmortem kidneys were transplanted into 401 people of age 64 (2.0% of all organ recipients) and 1,393 people of age 65 (7.1% of all organ recipients). The difference in waiting times between allocation programs for persons under age 65 (ETKAS, "Eurotransplant Kidney Allocation System") and those aged 65 and older (ESP, "Eurotransplant Senior Program") increased over the period of observation, from 2.6 years in 2006-2010 to 4.1 years in 2017-2020.

Conclusion: The rigid age limits in the current allocation rules for post-mortem kidney donations in Germany are prolonging the waiting times for transplants among patients aged 18 to 64. We think these rules need to be fundamentally reassessed.

肾移植的分配规则与年龄相关的等待时间--来自德国移植登记处的数据分析。
背景:德国目前对死后捐献肾脏的分配制度有严格的年龄限制,这可能会产生问题。新的德国国家移植登记处可以对这一问题进行数据分析:利用德国国家移植登记处的匿名数据,我们提取并评估了 2006-2020 年间通过欧洲移植组织在德国分配肾脏的受者和死后捐献者的信息:结果:我们分析了 2006-2020 年间德国 19 664 例肾移植的数据。肾移植等待时间的中位数为 5.8 年。其中,18 岁以下的等待时间中位数为 1.7 年;18 至 64 岁的等待时间中位数为 7.0 年;65 岁及以上的等待时间中位数为 3.8 年。在观察期内,有 401 名 64 岁的人和 1,393 名 65 岁的人接受了死后肾脏移植(分别占所有器官接受者的 2.0% 和 7.1%)。在观察期内,65岁以下人群(ETKAS,"欧洲器官移植肾脏分配系统")和65岁及以上人群(ESP,"欧洲器官移植老年计划")分配计划之间的等待时间差异从2006-2010年的2.6年增加到2017-2020年的4.1年:德国现行的死后肾脏捐赠分配规则中严格的年龄限制延长了 18 至 64 岁患者的移植等待时间。我们认为需要从根本上重新评估这些规则。
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来源期刊
Deutsches Arzteblatt international
Deutsches Arzteblatt international 医学-医学:内科
CiteScore
4.10
自引率
5.20%
发文量
306
审稿时长
4-8 weeks
期刊介绍: Deutsches Ärzteblatt International is a bilingual (German and English) weekly online journal that focuses on clinical medicine and public health. It serves as the official publication for both the German Medical Association and the National Association of Statutory Health Insurance Physicians. The journal is dedicated to publishing independent, peer-reviewed articles that cover a wide range of clinical medicine disciplines. It also features editorials and a dedicated section for scientific discussion, known as correspondence. The journal aims to provide valuable medical information to its international readership and offers insights into the German medical landscape. Since its launch in January 2008, Deutsches Ärzteblatt International has been recognized and included in several prestigious databases, which helps to ensure its content is accessible and credible to the global medical community. These databases include: Carelit CINAHL (Cumulative Index to Nursing and Allied Health Literature) Compendex DOAJ (Directory of Open Access Journals) EMBASE (Excerpta Medica database) EMNursing GEOBASE (Geoscience & Environmental Data) HINARI (Health InterNetwork Access to Research Initiative) Index Copernicus Medline (MEDLARS Online) Medpilot PsycINFO (Psychological Information Database) Science Citation Index Expanded Scopus By being indexed in these databases, Deutsches Ärzteblatt International's articles are made available to researchers, clinicians, and healthcare professionals worldwide, contributing to the global exchange of medical knowledge and research.
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