Data from: Attitudes among transplant professionals regarding shifting paradigms in eligibility criteria for live kidney donation

Background The transplant community increasingly accepts extended criteria live kidney donors, however, great (geographical) differences are present in policies regarding the acceptance of these donors, and guidelines do not offer clarity. The aim of this survey was to reveal these differences and to get an insight in both centre policies as well as personal beliefs of transplant professionals.
Methods An online survey was sent to 1128 ESOT-members. Questions were included about several extended donor criteria; overweight/obesity, older age, vascular multiplicity, minors as donors and comorbidities; hypertension, impaired fasting glucose, kidney stones, malignancies and renal cysts. Comparisons were made between transplant centres of three regions in Europe and between Europe and other countries worldwide.
Results 331 questionnaires were completed by professionals from 55 countries. Significant differences exist between regions in Europe in acceptance of donors with several extended criteria. Median refusal rate for potential live donors is 15%. Furthermore, differences are seen regarding pre-operative work-up, both in specialists who perform screening as in preoperative imaging. Conclusions Remarkably, 23.4% of transplant professionals sometimes deviate from their centre policy, resulting in more or less comparable personal beliefs regarding extended criteria. Variety is seen, proving the need for a standardized approach in selection, preferably evidence based.

背景
移植界日益认可扩大标准活体肾脏供体（extended criteria live kidney donors）的使用，但各国（地区）在该类供体的接收政策上存在显著的（地域）差异，且现有指南未对此提供明确规范。本研究旨在揭示此类差异，并深入了解移植中心的相关政策，以及移植专业人员的个人执业理念。

方法
本研究向1128名欧洲器官移植学会（European Society of Organ Transplantation, ESOT）会员发放了在线调查问卷。问卷涵盖多项供体扩大标准相关问题，包括超重/肥胖、高龄、多支血管、未成年人供体，以及合并症相关内容：高血压、空腹血糖受损、肾结石、恶性肿瘤、肾囊肿。本研究对欧洲三个区域的移植中心，以及欧洲与全球其他国家的移植中心进行了对比分析。

结果
来自55个国家的专业人员共完成331份问卷。欧洲不同区域在接收多类扩大标准供体的政策上存在显著差异。潜在活体供体的中位拒绝率为15%。此外，在术前评估流程方面，包括负责供体筛查的专科医师选择以及术前影像学检查方案，均存在明显差异。

结论
值得关注的是，23.4%的移植专业人员有时会偏离所在中心的既定政策，这使得他们在扩大标准供体的评估理念上呈现出一定的趋同性。本次研究发现的诸多差异，凸显了制定标准化供体筛选方案的必要性，且该方案最好基于循证医学证据。