TUMORS IN KIDNEY DONORS – ETHIC DILEMMA IN TRANSPLANTATION MEDICINE

Autor: MARKO BANIĆ, ALAN HORVAT, LEA KATALINIĆ, VESNA FURIĆ-ČUNKO, IVANA JURIĆ, TVRTKO HUDOLIN, ŽELJKO KAŠTELAN, NIKOLINA BAŠIĆ-JUKIĆ
Jazyk: chorvatština
Rok vydání: 2019
Předmět:
Zdroj: Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske
Volume 73
Issue 3
ISSN: 1848-8897
1330-0164
Popis: Primatelji solidnih organa imaju 3-4 puta veću pojavnost zloćudnih tumora, no osim tumora vlastitog tkiva, primatelji organa mogu razviti i zloćudnu bolest povezanu s darovanim organom. Prema istraživanjima izvan Republike Hrvatske, udio bolesnika koji razviju zloćudni tumor prenesen s darovatelja iznosi 0,01-0,05 %, što bi u hrvatskim uvjetima značilo 0,02-0,1 bolesnika s prenesenim zloćudnim tumorom godišnje. Rizičnima za prijenos tumora smatraju se darovatelji stariji od 45 godina te oni s preboljelim zloćudnim tumorom u anamnezi. Jasne smjernice još nisu razvijene pa svakom bolesniku treba pristupiti individualno i procijeniti rizike i boljitke postupaka. Četiri slučaja transplantacije bubrega s moždano-mrtvog darovatelja za koje se autopsijom doznalo za malignu bolest zabilježena su i na KBC-u Zagreb.
It is known that the incidence of malignant diseases is increased 3 to 4 times when the population of solid organs recipients is observed. Apart from the tumours developed from one's own tissues, tumour recipients may develop a malignant tumour related to the donated organ. The chance of developing such a disease is far smaller than the one of developing a malignant disease originating from one's own tissues but the chance is not non-existant. It is necessary to examine whether such a risk is worth taking and whether the donated organ should be explanted in the case of discovering a malignancy in donor. Another problem is the fact that a portion of such tumours is discovered not before the deceased donor's obduction. Acorrding to researches outside of Croatia, 0,01-0,05% of kidney recipients develop a malignancy transmitted from the donor. In Croatian terms, that would be equivalent to 0,02-0,1 persons per year. Increased risk groups would be donors over the age of 45 and donors with a history of malignant disease. There are no clear guidelines developed yet but there are some widely-accepted procedures in certain situations. Each patient must be individually evaluated and cost-benefit analysis must be taken into account. Four cases occured in the Hospital University Center Zagreb when the autopsy discovered a malignancy in kidney donors.
Databáze: OpenAIRE
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