Causas de exclusión de donantes renales vivos en el servicio de trasplante de un hospital de tercer nivel del noroeste de México

K. Guzmán-Flores, A. Gurrola-Castillo, E. Ortega-Villa, JA Lugo-Machado
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Abstract

Objective: To identify the causes for exclusion of living kidney donors at a third-level hospital in northwestern Mexico. Materials and methods: An observational, cross-sectional, descriptive and retrospective study, in which the medicalrecords of candidates for living kidney donation were evaluated from January 1, 2019 to December 31, 2021. Results: Out of the 30 selected records, only 6.6 % (2) were chosen as donors, i.e., the rejection rate of the potential candidates was 93.3 % (28). The average age was 40.7 years; when divided into age groups, it was observed that 7.44 % were ≤ 39 years, 5.31 % were ≥ 50 years and 4.25 % were in the 40–49 age range. The main pathologies that caused therejection of living donors were chronic diseases such as unknown renal disease, obesity, diabetes mellitus, systemic hypertension and heart diseases, which accounted for 60.7 %. The desire to donate was more frequent among blood relatives than non-blood relatives. In the case of blood relatives, i.e., siblings, parents, children, uncles, aunts, etc., 64.2 % were rejected, while 34.7 % of non-blood relatives, including spouses and friends, were rejected.Conclusions: Based on the body mass index (BMI), the results showed that overweight and obesity were the main causes of exclusion, a situation that is consistent with the Mexican epidemiological profile. The number of living donors at ourcenter has been reduced because most of the population is not healthy and has obesity, which affects the willingness to be a candidate for living kidney donation.
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墨西哥西北部一家三级医院移植服务中排除活肾供体的原因
目的:探讨墨西哥西北部某三级医院排除活体肾供者的原因。材料与方法:采用观察性、横断面、描述性和回顾性研究,对2019年1月1日至2021年12月31日的活体肾脏捐献候选人病历进行评估。结果:30例入选记录中,仅有6.6%(2例)被选为供体,即潜在候选人的拒绝率为93.3%(28例)。平均年龄40.7岁;按年龄分组,7.44%的患者年龄≤39岁,5.31%的患者年龄≥50岁,4.25%的患者年龄在40 ~ 49岁。引起活体供体排斥反应的主要病理为慢性疾病,如未知肾脏疾病、肥胖、糖尿病、全身性高血压和心脏病,占60.7%。有血亲关系的人比没有血亲关系的人更愿意献血。在血亲中,即兄弟姐妹、父母、子女、叔叔、阿姨等,被拒绝的比例为64.2%,而非血亲,包括配偶和朋友,被拒绝的比例为34.7%。结论:基于身体质量指数(BMI),结果显示超重和肥胖是排除的主要原因,这一情况与墨西哥的流行病学概况一致。我们中心的活体捐赠者数量减少了,因为大多数人都不健康,肥胖,这影响了活体肾脏捐赠的意愿。
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