A Systematic Review of Kidney Paired Donation: Applying Lessons From Historic and Contemporary Case Studies to Improve the US Model
A Systematic Review of Kidney Paired Donation: Applying Lessons From Historic and Contemporary Case Studies to Improve the US Model
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肾脏配对捐赠的系统回顾：应用历史和当代案例研究的经验教训来改进美国模式
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发表时间：
2014
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通讯作者：
B. Ellison
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作者：
B. Ellison
由于肾脏配对捐赠（KPD）是一个年轻的做法，没有详细的清单配对交换的历史，运营KPD组织的活动，或改进的建议。本文试图通过对KPD的全面分析来解决这些问题。第一部分简要介绍了KPD的背景，包括肾脏相容性和KPD的形式。第二部分详细介绍了KPD计划的历史和独特的特点，国际和美国国内。接下来，第三部分介绍了国家配对组织和个人移植中心的案例研究，强调差异和相似之处，可能会解释性能的变化。最后，第四部分确定了KPD在美国发展所面临的三大挑战-患者池的巴尔干化，移植中心之间缺乏协调，以及积极的交叉匹配中断-并根据机构最佳实践提出建议，以减轻每一个挑战。通过广泛的文献综述，对KPD的历史和建议进行了汇编。案例研究中的许多细节都是从对移植中心和配对组织代表的采访中获得的。
Because kidney paired donation (KPD) is a young practice, there exists no detailed inventory of the history of paired exchanges, the activities of operating KPD organizations, or recommendations for improvement. This paper attempts to address each of these considerations by providing a comprehensive analysis of KPD. The first section gives a brief background on KPD, including a review of kidney compatibility and the forms of KPD. The second details the history and distinctive features of KPD programs, internationally and within the United States. Next, the third section presents case studies of national pairing organizations and individual transplant centers, highlighting differences and similarities that may explain variations in performance. Finally, the fourth section identifies the three major challenges facing the growth of KPD in the US – the balkanization of patient pools, lack of coordination among transplant centers, and positive cross match disruptions – and offers recommendations based on institutional best practices to mitigate each. Information on the history of KPD and recommendations were compiled through an extensive literature review. Many of the details included in the case studies were garnered from interviews with representatives from transplant centers and pairing organizations.