Causes of Ineligibility for Recipients in Living Kidney Transplantation
| Autor: | A. Kondo, Ichiro Nakajima, Ichiro Koyama, N. Masaki, Kazuhiro Iwadoh, S. Fuchinoue |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Heart disease Adolescent 030232 urology & nephrology Disease Malignancy 050105 experimental psychology 03 medical and health sciences Young Adult 0302 clinical medicine Japan Internal medicine Surveys and Questionnaires Cardiovascular problems Living Donors Medicine Humans 0501 psychology and cognitive sciences Young adult Ineligibility Child Kidney transplantation Aged Aged 80 and over Transplantation business.industry 05 social sciences Living kidney transplantation Middle Aged medicine.disease Kidney Transplantation Transplant Recipients Kidney Failure Chronic Surgery Female business |
| Zdroj: | Transplantation proceedings. 50(4) |
| ISSN: | 1873-2623 |
| Popis: | Background Even if a living donor candidate exists, there are some cases that do not result in kidney transplantation (KTx) due to problems on the recipient side. The aim of this study was to clarify causes of ineligibility for KTx in these cases, so as to make RTx more applicable for patients. Methods We targeted 470 patients with end-stage renal disease who applied for the primary kidney KTx from 2010 to 2012. Then we selected those who were not applicable for KTx and investigated recipient causes of ineligibility for KTx or not receiving KTx. Results The average age of recipients was 47.6 ± 12.9 (7–82) years. A majority of the 470 patients were male (n = 305, 64.9%). Two hundred ninety-seven patients intended to receive a living donor KTx and the others hoped for a deceased donor KTx. Of the 297 patients, 207 (70.0%) underwent KTx and 9 (1.9%) were being prepared for KTx at the time of the survey. Eighty-three patients (27.9%) did not receive a living KTx, with 59 of these due to recipient-related problems and 30 due to donor-related problems. We further classified the reasons for these 59 recipients not undergoing KTx as follows: (1) unclear reasons (35.6%); (2) insufficient intention to receive transplant (13.6%); (3) heart disease (10.2%); (4) malignancy (8.5%); (5) immunologic risks (5.1%); (6) death during the waiting period (5.1%); (7) cerebrovascular events (5.1%); (8) cardiovascular problems (5.1%); (9) psychiatric disorders (3.4%); and (10) infections (3.4%). Conclusion Nearly 50% of the reasons for ineligibility as a recipient were related to their intention to receive KTx, with 94.9% of the nontransplanted cases due to nonimmunologic reasons. Thanks to the recent advances in immunosuppressive therapy, there were only 3 patients who could not undergo KTx due to immunologic risks. Based on these results, transplant surgeons should not only emphasize physical evaluation but should also pay careful attention to the recipient's intention to receive KTx. |
| Databáze: | OpenAIRE |
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