Reasons and effects of the decline of willing related potential living kidney donors  

作　　者：Rabea Ahmed Gadelkareem Amr Mostafa Abdelgawad Nasreldin Mohammed Ahmed Reda Nashwa Mostafa Azoz Mohammed Ali Zarzour Hisham Mokhtar Hammouda Mahmoud Khalil 

机构地区：[1]Department of Urology,Assiut Urology and Nephrology Hospital,Faculty of Medicine,Assiut University,Assiut 71515,Egypt [2]Department of Internal Medicine-Nephrology Unit,Assiut University Hospital,Faculty of Medicine,Assiut University,Assiut 71515,Egypt

出　　处：《World Journal of Transplantation》2023年第5期276-289,共14页世界移植杂志

摘　　要：BACKGROUND Although the availability of related living donors(LDs)provides a better chance for receiving kidney transplantation(KT),the evaluation protocols for LD selection remain a safeguard for the LD’s safety.These protocols are variable from one center to another,resulting in variable rates of decline of the potential LDs(PLDs).The decline of willing PLDs may occur at any stage of evaluation,starting from the initial contact and counseling to the day of operation.AIM To identify the causes of the decline of PLDs,the predictors of PLD candidacy,and the effect on achieving LDKT.METHODS A retrospective study was performed on the willing PLDs who attended our outpatient clinic for kidney donation to their related potential recipients between October 2015 and December 2022.The variables influencing their candidacy rate and the fate of their potential recipients were studied.Two groups of PLDs were compared:Candidate PLDs after a completed evaluation vs non-candidate PLDs with a complete or incomplete evaluation.A multivariate logistic regression was performed to assess the factors contributing to the achievement of PLD candidacy.RESULTS Of 321 willing PLDs,257 PLDs(80.1%)accessed the evaluation to variable extents for 212 potential recipients,with a mean age(range)of 40.5±10.4(18-65)years,including 169 females(65.8%).The remaining 64 PLDs(19.9%)did not access the evaluation.Only 58 PLDs(18.1%)succeeded in donating,but 199 PDLs(62.0%)were declined;exclusion occurred in 144 PLDs(56.0%)for immunological causes(37.5%),medical causes(54.9%),combined causes(9.7%),and financial causes(2.1%).Regression and release occurred in 55 PLDs(17.1%).The potential recipients with candidate PLDs were not significantly different from those with non-candidate PLDs,except in age(P=0.041),rates of completed evaluation,and exclusion of PLDs(P<0.001).There were no factors that independently influenced the rate of PLD candidacy.Most patients who failed to have KT after the decline of their PLDs remained on hemodialysis for 6 mo to 6 ye

关 键 词：Donor decline Donor evaluation Donor exclusion Kidney transplantation Living kidney donors Related living donors 

分 类 号：R69[医药卫生—泌尿科学]