Why Living Kidney Donors Are Declined: A Swiss Single Center Observation Over 15 Years.

Christian Kuhn, Aurelia Schnyder, Wolfgang Ender, Anna Wiegand, Patrick Folie, Isabelle Binet, Alexander Ritter
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Abstract

Introduction: Living kidney donation plays a crucial role in addressing organ shortage. Careful and holistic donor assessment is required to minimize donor risks. While acceptance patterns are well documented, donor candidates beyond the threshold remain largely unexamined. This study aims to analyze donor evaluations to identify reasons and trends for donor decline.

Methods: In this retrospective observational study, we analyzed prospectively collected data of 275 potential living kidney donor evaluated at our center between 2007 and 2021, assessing demographic and health characteristics, as well as the reasons for donor decline.

Results: Of the 275 donor candidates evaluated, 197 (71.6%) were declined. The primary reasons were medical and surgical issues (32.7%), particularly kidney-related conditions (9.5%), followed by immunological factors (21.1%) and psychosocial concerns (12.7%). Interestingly, there was a trend towards accepting medically more complex donors over the study period, with an increase in mean donor age and lower estimated glomerular filtration rate of accepted donors.

Conclusion: Donor decline is influenced by a range of medical, immunological, and psychosocial factors. These findings highlight the importance of individualized assessments and call for further research into overcoming donation barriers and evaluating long-term outcomes, particularly for medically complex donors, to optimize safe and effective living kidney donation.

为什么活体肾脏捐献者减少:瑞士单中心15年观察。
活体肾脏捐献在解决器官短缺问题中起着至关重要的作用。需要对捐赠者进行仔细和全面的评估,以尽量减少捐赠者的风险。虽然接受模式有很好的记录,但超出阈值的捐助者候选人基本上没有经过审查。本研究旨在分析捐赠者的评价,以确定捐赠者减少的原因和趋势。方法:在这项回顾性观察性研究中,我们前瞻性地分析了2007年至2021年间在我们中心评估的275名潜在活体肾供者的数据,评估了人口统计学和健康特征,以及供者减少的原因。结果:275例候选供体中,197例(71.6%)被拒绝。主要原因是医疗和手术问题(32.7%),特别是肾脏相关疾病(9.5%),其次是免疫因素(21.1%)和社会心理问题(12.7%)。有趣的是,在研究期间出现了接受医学上更复杂的供体的趋势,平均供体年龄增加,接受供体的肾小球滤过率估计较低。结论:供体减少受一系列医学、免疫学和社会心理因素的影响。这些发现强调了个性化评估的重要性,并呼吁进一步研究克服捐赠障碍和评估长期结果,特别是对于医疗复杂的捐赠者,以优化安全有效的活体肾脏捐赠。
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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