尽管肾脏供体短缺，美国还是丢弃了数千个肾脏

研究表明，尽管肾脏供体短缺，美国还是丢弃了数千个肾脏

Despite the 93,000 patients in the US seeking a kidney transplant, a new report reveals that some 3,500 donated kidneys go unused and even thrown away every year.

尽管美国有9.3万名患者寻求肾移植，但一份新的报告显示，每年约有3500名捐献的肾脏被闲置，甚至被扔掉。

A study published in JAMA Internal Medicine this week found that 17% of donated kidneys in the US were discarded during a 10-year period. By comparison, in France, only about 9% of donated kidneys went unused during the study period.

本周发表在《美国医学会内科学杂志》上的一项研究发现，美国17%的捐赠肾脏在10年内被丢弃。相比之下，在法国，只有约9%的捐赠肾脏在研究期间未被使用。

Why the waste? According to the report, doctors here in the US are less inclined to risk using lower-quality kidneys, even though previous studies have shown that even less desirable kidneys, such as older kidneys and those with abnormalities, are still better than dialysis.

为什么浪费?根据报告，美国的医生不太倾向于冒险使用低质量的肾脏，尽管先前的研究表明，即使是不太理想的肾脏，如老年肾脏和异常肾脏，仍然比透析更好。

In France, doctors are more willing to use kidneys from deceased patients who suffered from illnesses such as diabetes or hypertension.

在法国，医生更愿意使用死于糖尿病或高血压等疾病的病人的肾脏。

Cost may also be a factor in US doctors’ reticence to use affected kidneys, since these transplants may also result in extended hospital stays.

成本可能也是美国医生不愿使用受影响肾脏的一个因素，因为这些移植也可能导致住院时间延长。

And, without a consistent set of guidelines in the US, some regions discard more kidneys than others based on their own opinions about whether a kidney is viable, according to a 2016 study by the National Kidney Foundation. That study found that as many as 50% of discarded kidneys could have been transplanted.

而且，根据美国国家肾脏基金会(National kidney Foundation) 2016年的一项研究，在美国没有一套统一的指导方针的情况下，一些地区会根据自己对肾脏是否可行的看法，丢弃更多的肾脏。该研究发现，多达50%的废弃肾脏可以被移植。

The United Network for Organ Sharing (UNOS) — the US’ transplant governing body — attempted to improve the discard rate by creating a kidney donor profile index in 2012, which rates how long it predicts a kidney will hold up. The network even lowered its standards in 2014 so that lesser kidneys would be considered.

美国器官共享联合网络(UNOS)——美国的移植管理机构——试图通过在2012年建立一个肾脏捐赠者概况指数来提高弃置率，该指数对预测一个肾脏将维持多久进行评估。该网络甚至在2014年降低了标准，以便考虑使用更小的肾脏。

The problem is wide-reaching: More than 37 million Americans suffer from chronic kidney disease, with roughly 5,000 of these patients dying each year on the transplant waiting list.

这个问题影响深远：超过3700万美国人患有慢性肾病，每年大约有5000名患者在移植候诊名单上死亡。

Still, the number of wasted kidneys continues to rise, up to 30% in some regions, according to a study published in January 2019.

然而，根据2019年1月公布的一项研究，一些地区的肾脏浪费数量仍在继续增加，高达30%。

In the end, “risk-averse” policies in US transplant programs hit patients hardest, write Dr. Ryoichi Maenosono and Dr. Stefan G. Tullius of Brigham and Women’s Hospital, in a commentary article attached to the JAMA study.

最后，美国布莱根妇女医院的Ryoichi Maenosono博士和Stefan G. Tullius博士在《美国医学会杂志》研究的一篇评论文章中写道，美国移植项目中的“风险规避”政策对患者的打击最大。

“Hospital administrators and patients alike are attracted by superficial five-star ranking approaches that are easy to read but not necessarily reflective of the approach of individual programs aiming to provide their patients on waiting lists with the best opportunities.”

“医院管理者和患者都被表面的五星级排名方法所吸引，这些方法易于阅读，但不一定反映出个人项目的方法，其目的是为候诊名单上的患者提供最佳机会。”