When is Transplantation with a 'Marginal Kidney' Justifiable?
| Autor: | Mitra Mahdavi-Mazdeh, Alireza Heidary Rouchi |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Graft Rejection
medicine.medical_specialty Tissue and Organ Procurement medicine.medical_treatment 030232 urology & nephrology Histocompatibility Testing 050108 psychoanalysis Donor Selection 03 medical and health sciences 0302 clinical medicine Quality of life Cadaver medicine Humans 0501 psychology and cognitive sciences Renal replacement therapy Intensive care medicine Kidney transplantation Survival analysis Transplantation Kidney Donor selection business.industry Graft Survival 05 social sciences General Medicine medicine.disease Kidney Transplantation Survival Analysis Tissue Donors Renal Replacement Therapy surgical procedures operative medicine.anatomical_structure Kidney Failure Chronic business |
| Zdroj: | Annals of Transplantation. 21:463-468 |
| ISSN: | 2329-0358 |
| DOI: | 10.12659/aot.898405 |
| Popis: | The ability of kidney transplantation to improve quality of life has made this therapeutic modality the treatment of choice among renal replacement therapies; however, the continuing organ shortage has forced the use of marginal kidneys as a supplementary source of allografts. It has been repeatedly suggested that failed kidney transplant recipients have greater morbidity and mortality compared with dialysis patients with no renal transplant history. Achieving an optimal balance between the advantages of kidney transplant and disadvantages of allografts with marginal quality is a topic of controversy in transplant medicine. The major and potentially life-threatening complications of immunosuppressive therapies and shorter lifespan following graft failure necessitate a reappraisal of kidney transplant programs from expanded-criteria deceased donors, which can neither necessarily give dialysis patients a better quality of life nor a significant survival benefit, especially in settings with additional diminished graft survival due to HLA-mismatch. It should be offered just to those with short life expectancy and with HLA-matching. The last item is very important in countries without mandatory HLA-matching protocols for kidney transplantation programs. |
| Databáze: | OpenAIRE |
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