Cadaveric Renal Transplantation under the American Organ Allocation System1
| Autor: | Baburao Koneru, Robert D. Gordon, Andreas G. Tzakis, Thomas E. Starzl, Andrei C. Stieber, Thomas R. Hakala, William B. Lopatin, Sandi Mitchell, Ron Shapiro |
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| Rok vydání: | 2015 |
| Předmět: |
United Network for Organ Sharing
medicine.medical_specialty business.industry media_common.quotation_subject medicine.disease Postoperative management Transplantation Point system Software deployment Medicine Quality (business) business Cadaveric spasm Intensive care medicine Kidney transplantation media_common |
| DOI: | 10.1159/000416901 |
| Popis: | The allocation of organs and the optimal form of postoperative management are two of the most important issues in renal transplantation. On 1 January 1986, a system for equitable deployment of cadaveric organs was put into place at the University of Pittsburgh Transplantation Center [1]. The system provided merit points for time waiting, quality of antigen match, degree of presensitization as reflected by a preformed antibody analysis (PRA), medical urgency, and logistical factors which would add to the risk by increasing preservation time. The point system was a step toward avoiding ad hoc decisions about who would receive a given kidney and a movement toward computerization in selection. Ultimately, the foregoing point system was adopted essentially without change for national use by the United Network for Organ Sharing (UNOS), a private and previously voluntary organization which had been given by law the responsibility for developing a distribution scheme. However, the influence of such a system which systemically assures equitable access for all patients, including those at high medical and immunologic risk, has never been assessed. It is our intention to analyze here our experience with the point system, with particular reference to the effect of immunosuppressive regimens. |
| Databáze: | OpenAIRE |
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