Care of international living kidney donor candidates in the United States: A survey of contemporary experience, practice, and challenges.

Autor: Lentine KL; Saint Louis University Center for Abdominal Transplantation, St. Louis, Missouri, USA., Motter JD; Johns Hopkins Comprehensive Transplant Center, Baltimore, Maryland, USA., Henderson ML; Johns Hopkins Comprehensive Transplant Center, Baltimore, Maryland, USA., Hays RE; University of Wisconsin Hospital and Clinics, Madison, Wisconsin, USA., Shukhman E; Cedars-Sinai Comprehensive Transplant Center, Los Angeles, California, USA., Hunt J; Recanati/Miller Transplantation Institute, Mount Sinai Hospital, New York, NY, USA., Al Ammary F; Johns Hopkins Comprehensive Transplant Center, Baltimore, Maryland, USA., Kumar V; University of Alabama Comprehensive Transplant Center, Birmingham, Alabama, USA., LaPointe Rudow D; Recanati/Miller Transplantation Institute, Mount Sinai Hospital, New York, NY, USA., Van Pilsum Rasmussen SE; Johns Hopkins Comprehensive Transplant Center, Baltimore, Maryland, USA., Nishio-Lucar AG; University of Virginia, Charlottesville, Virginia, USA., Schaefer HM; Vanderbilt Transplant Center, Nashville, Tennessee, USA., Cooper M; MedStar Georgetown Transplant Institute, Washington, District of Columbia, USA., Mandelbrot DA; Cedars-Sinai Comprehensive Transplant Center, Los Angeles, California, USA.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2020 Nov; Vol. 34 (11), pp. e14064. Date of Electronic Publication: 2020 Oct 19.
DOI: 10.1111/ctr.14064
Abstrakt: The evaluation and care of non-US citizen, non-US residents who wish to come to the United States to serve as international living kidney donors (ILKDs) can pose unique challenges. We surveyed US transplant programs to better understand practices related to ILKD care. We distributed the survey by email and professional society list-servs (Fall 2018, assessing 2017 experience). Eighty-five programs responded (36.8% program response rate), of which 80 considered ILKD candidates. Only 18 programs had written protocols for ILKD evaluation. Programs had a median of 3 (range: 0,75) ILKD candidates who initiated contact during the year, from origin countries spanning 6 continents. Fewer (median: 1, range: 0,25) were approved for donation. Program-reported reasons for not completing ILKD evaluations included visa barriers (58.6%), inability to complete evaluation (34.3%), concerns regarding follow-up (31.4%) or other healthcare access (28.6%), and financial impacts (21.4%). Programs that did not evaluate ILKDs reported similar concerns. Staff time required to evaluate ILKDs was estimated as 1.5-to-3-times (47.9%) or >3-times (32.9%) that needed for domestic candidates. Among programs accepting ILKDs, on average 55% reported successful completion of 1-year follow-up. ILKD evaluation is a resource-intensive process with variable outcomes. Planning and commitment are necessary to care for this unique candidate group.
(© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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