Seasonal Patterns of Living Kidney Donation in the United States From 1995 to 2019

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2024-09-11 DOI:10.1111/ctr.15454

Andrew Arking, Gabriella Kaddu, Allan B. Massie, Dorry L. Segev, Jacqueline Garonzik-Wang, Jon Snyder, Elizabeth A. King, Abimereki D. Muzaale, Fawaz Al Ammary

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Abstract

Background

The number of living kidney donors in the United States has declined since 2005, with variations based on the donor–recipient relationship. The reasons for this decline are unclear, and strategies to mitigate declined donations remain elusive. We examined the change in donor number monthly (within-year) versus annually (between-years) to inform potentially modifiable factors for future interventions.

Methods

In this registry-based cohort analysis of 141 759 living kidney donors between 1995 and 2019, we used linear mixed-effects models for donor number per month and year to analyze between-year and within-year variation in donation. We used Poisson regression to quantify the change in the number of donors per season before and after 2005, stratified by donor–recipient relationship and zip-code household income tertile.

Results

We observed a consistent summer surge in donations during June, July, and August. This surge was statistically significant for related donors (incidence rate ratio [IRR] range: 1.12–1.33) and unrelated donors (IRR range: 1.06–1.16) across donor income tertiles.

Conclusion

Our findings indicate lower rates of living kidney donation in non-summer months across income tertiles. Interventions are needed to address barriers to donation in non-summer seasons and facilitate donations throughout the year. Since the Organ Donor Leave Law provides a solid foundation for supporting year-round donation, extending the law's provisions beyond federal employees may mitigate identified seasonal barriers.

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1995 年至 2019 年美国活体肾脏捐赠的季节性模式

背景自 2005 年以来，美国的活体肾脏捐献者人数一直在下降，根据捐献者和接受者的关系而有所不同。造成这一下降的原因尚不清楚，缓解捐赠数量下降的策略也仍未出台。我们研究了每月（年内）和每年（年间）捐献者人数的变化情况，以便为未来的干预措施提供潜在的可调整因素。方法在这项对 1995 年至 2019 年间 141 759 名活体肾脏捐献者进行的基于登记的队列分析中，我们使用每月和每年捐献者人数的线性混合效应模型来分析捐献的年际和年内变化。我们使用泊松回归来量化 2005 年前后每个季节捐献者人数的变化，并按捐献者与受捐者的关系和邮政编码家庭收入三等分进行分层。结果我们观察到，在 6 月、7 月和 8 月期间，夏季捐赠人数持续激增。在不同的捐赠者收入分层中，有亲属关系的捐赠者（发生率比 [IRR] 范围：1.12-1.33）和无亲属关系的捐赠者（发生率比 [IRR] 范围：1.06-1.16）的捐赠激增具有显著的统计学意义。结论我们的研究结果表明，不同收入阶层在非夏季的活体肾脏捐赠率较低。需要采取干预措施，消除非夏季捐赠的障碍，促进全年的捐赠。由于《器官捐献者休假法》为支持全年捐献提供了坚实的基础，因此将该法的规定扩大到联邦雇员以外的人群可能会缓解已发现的季节性障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.